Santangelo Gloria, Ielasi Alfonso, Antonio Scopelliti Pasquale, Pattarino Francesco, Tespili Maurizio
Cardiology Division, Azienda Socio Sanitaria Territoriale Bergamo Est , Bolognini Hospital, Seriate (BG), Italy.
J Atr Fibrillation. 2016 Dec 31;9(4):1509. doi: 10.4022/jafib.1509. eCollection 2016 Dec.
A 86-year-old woman with first diagnosed atrial fibrillation (AF) underwent mitral valve annuloplasty 10 years before was admitted to our Unit due to congestive heart failure. Trans-thoracic echocardiogram (TTE) revealed a large fluctuant echogenic mass in the posterior wall of the left atrium. Trans-esophageal echo (TEE) showed the origin of the mass within the left atrial appendage. An adjusted dose of the novel oral anticoagulant (NOAC) apixaban, was prescribed. A complete disappearance was appreciated by examination at 12 weeks after the first drug administration. Although apixaban, resulted superior to warfarin in preventing stroke and thrombo-embolic events in patients with non valvular AF, while causing less bleeding, few data are actually available regarding the efficacy and safety of this drug in left atrium and appendage thrombosis management. Our report shows that this NOAC could be a simple and useful option to manage huge atrial thrombosis in very elderly patients.
一名首次诊断为心房颤动（AF）的86岁女性，10年前接受了二尖瓣环成形术，因充血性心力衰竭入住我院。经胸超声心动图（TTE）显示左心房后壁有一个巨大的波动回声团块。经食管超声心动图（TEE）显示团块起源于左心耳。给予调整剂量的新型口服抗凝药（NOAC）阿哌沙班。首次给药12周后检查发现团块完全消失。尽管在预防非瓣膜性AF患者的中风和血栓栓塞事件方面，阿哌沙班优于华法林，且出血较少，但关于该药物在左心房和心耳血栓管理中的疗效和安全性，实际可用的数据很少。我们的报告表明，这种NOAC可能是管理高龄患者巨大心房血栓的一种简单而有用的选择。
