一例罕见的早期生物瓣膜血栓形成伴急性心力衰竭经血栓切除术成功救治的病例报告。
A rare case report of early bioprosthetic valve thrombosis presenting with acute heart failure salvaged by thrombectomy.
作者信息
Fan Jingya, Teng Peng, Zou Yu, Ma Liang
机构信息
Department of Cardiothoracic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
, Postal Address: 79#, Qingchun Road, Hangzhou, 310000, Zhejiang, China.
出版信息
J Cardiothorac Surg. 2017 Mar 27;12(1):19. doi: 10.1186/s13019-017-0581-9.
BACKGROUND
Bioprosthetic valve thrombosis is previously considered as an extremely rare complication which hasn't been systemically recognized and understood.
CASE PRESENTATION
Herein, we present an unusual case of a patient manifesting with acute heart failure, secondary to thrombus formation in a porcine aortic bioprosthesis which was implanted 11 months prior to hospitalization. Due to the patient's poor heart function and intraoperative findings, thrombectomy was performed. For our best knowledge, cases of early bioprosthetic valve thrombosis presenting with acute heart failure have seldomly been reported.
CONCLUSION
Our study reviews predisposing factors, typical echocardiographic features and treatment for bioprosthetic valve thrombosis and it should be considered as a reason for bioprosthetic malfunction. A combination of clinical and echocardiographic features can help for diagnosis preoperatively. In some certain circumstances, early reoperation can be avoided if anticoagulant therapy works.
背景
生物人工瓣膜血栓形成以前被认为是一种极其罕见的并发症，尚未得到系统的认识和理解。
病例报告
在此，我们报告一例不寻常的病例，一名患者因住院前11个月植入的猪主动脉生物人工瓣膜内血栓形成继发急性心力衰竭。由于患者心功能差及术中所见，行血栓切除术。据我们所知，很少有早期生物人工瓣膜血栓形成伴急性心力衰竭的病例报道。
结论
我们的研究回顾了生物人工瓣膜血栓形成的易感因素、典型超声心动图特征及治疗方法，应将其视为生物人工瓣膜功能障碍的一个原因。临床和超声心动图特征相结合有助于术前诊断。在某些特定情况下，如果抗凝治疗有效，可避免早期再次手术。
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