Suzuyama Hiroto, Taguchi Eiji, Miyamoto Shinzo, Nuki Toshiaki, Nozoe Masatsugu, Sawamura Tadashi, Sakamoto Tomohiro, Nakao Koichi
Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center, 5-3-1 Chikami, Kumamoto 861-4193, Japan.
J Cardiol Cases. 2011 Feb 17;3(2):e86-e89. doi: 10.1016/j.jccase.2011.01.003. eCollection 2011 Apr.
An 87-year-old woman who had metastatic lung cancer presented with intermittent chest discomfort. The emergent coronary angiogram showed a giant saddle thrombus at the left main coronary artery bifurcation without flow limitation. We performed thrombolysis with unfractionated heparin and warfarin under careful observation of the thrombus with a 320-row area detector computed tomography (ADCT). Ten days later, the second examination with ADCT revealed complete resolution of the saddle thrombus. During the follow-up, neither chest pain nor enzymatic cardiac damage was reported. In this carefully observed case, a less invasive strategy instead of catheter intervention or strong thrombolysis might have led to a favorable clinical outcome.
一名患有转移性肺癌的87岁女性出现间歇性胸部不适。急诊冠状动脉造影显示左主冠状动脉分叉处有一个巨大的鞍状血栓，无血流受限。我们在使用320排区域探测器计算机断层扫描（ADCT）仔细观察血栓的情况下，用普通肝素和华法林进行了溶栓治疗。十天后，ADCT复查显示鞍状血栓完全溶解。在随访期间，未报告胸痛或心肌酶损伤。在这个经过仔细观察的病例中，一种侵入性较小的策略而非导管介入或强力溶栓可能带来了良好的临床结果。
