利伐沙班治疗期间发生机械瓣膜血栓形成：新型抗凝剂真的是一种选择吗？
Mechanical Valve Thrombosis on Rivaroxaban: Are Novel Anticoagulants Really an Option?
作者信息
Kumar Vishesh, Kelly Shawn, Raizada Amol, Yee Jimmy, Anuwatworn Amornpol, Stys Adam, Stys Maria
机构信息
University of South Dakota, Sanford School of Medicine, Vermillion, South Dakota.
出版信息
Methodist Debakey Cardiovasc J. 2017 Apr-Jun;13(2):73-75. doi: 10.14797/mdcj-13-2-73.
Abstract
This is a case of a 54-year-old female with a history of mechanical aortic valve replacement who presented in cardiogenic shock. Her primary care provider started her on rivaroxaban for anticoagulation therapy. An urgent transesophageal echocardiogram revealed a significant gradient and thrombosis on one leaflet of the valve that was immobile. Given that she was not a surgical candidate, she underwent thrombolysis. However, she later died due to complications from the thrombotic valve. The utility of target-specific oral anticoagulants has yet to be established in clinical practice.
摘要
这是一例54岁女性患者，有机械主动脉瓣置换病史，现出现心源性休克。她的初级保健医生开始让她服用利伐沙班进行抗凝治疗。紧急经食管超声心动图显示瓣膜的一个瓣叶存在明显压差和血栓形成，该瓣叶活动受限。鉴于她不适合手术，遂接受了溶栓治疗。然而，她后来因血栓形成的瓣膜引发的并发症而死亡。在临床实践中，靶向特异性口服抗凝剂的效用尚未得到证实。
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