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Immediate disappearance of large thrombus in left atrium without evidence of systemic embolization after heparin treatment.肝素治疗后左心房内大血栓立即消失，无全身栓塞证据。
J Cardiol Cases. 2012 Jan 12;5(3):e160-e162. doi: 10.1016/j.jccase.2011.12.001. eCollection 2012 Jun.
2
[Transesophageal echocardiography in patients with atrial fibrillation, candidates for cardioversion: usefulness and limitations].[经食管超声心动图在房颤患者（心脏复律候选者）中的应用：实用性与局限性]
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J Cardiol. 1996 Aug;28(2):93-7.
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A Case of Embolism due to a Floating Thrombus Migrating from the Left Atrial Appendage to the Ostium of the Celiac Artery.一例由左心耳漂浮血栓迁移至腹腔动脉开口处导致的栓塞病例。
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本文引用的文献

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Surgical technique for massive mural thrombus in the left atrium.
J Card Surg. 2007 Sep-Oct;22(5):443-4. doi: 10.1111/j.1540-8191.2007.00457.x.
2
Thrombolytic therapy for acute left atrial thrombus formation in one patient with heart failure and atrial fibrillation.一名心力衰竭合并心房颤动患者急性左心房血栓形成的溶栓治疗。
Circ J. 2007 Apr;71(4):604-7. doi: 10.1253/circj.71.604.
3
[Cauliflower-like giant left atrial thrombus successfully treated by anticoagulants without systemic complication: a case report].[抗凝剂成功治疗菜花状巨大左心房血栓且无全身并发症：一例报告]
J Cardiol. 2003 Jun;41(6):291-5.
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Clinical features of intracardiac thrombosis based on echocardiographic observation.
Jpn Circ J. 1984 Jan;48(1):75-82. doi: 10.1253/jcj.48.75.
5
Atrial fibrillation. I. A study of atrial thrombosis and systemic embolism in a necropsy material.心房颤动。一、尸检材料中心房血栓形成与系统性栓塞的研究。
Acta Med Scand. 1969 May;185(5):373-9.

肝素治疗后左心房内大血栓立即消失，无全身栓塞证据。

Immediate disappearance of large thrombus in left atrium without evidence of systemic embolization after heparin treatment.

作者信息

Oishi Gaku, Hodatsu Akihiko, Mori Mika, Fujioka Kensuke, Hayashi Kenshi, Konno Tetsuo, Kawashiri Masa-Aki, Yamagishi Masakazu

机构信息

Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan.

出版信息

J Cardiol Cases. 2012 Jan 12;5(3):e160-e162. doi: 10.1016/j.jccase.2011.12.001. eCollection 2012 Jun.

DOI:10.1016/j.jccase.2011.12.001
PMID:30532929
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6265420/
Abstract

We report an unusual case with giant left atrial thrombus which disappeared soon after starting anticoagulation without evidence of further systemic embolism. A 75-year-old female with non-valvular atrial fibrillation suddenly complained of pain of her right arm and left leg. Contrast-enhanced computed tomography showed occlusion of right brachial and left popliteal arteries. Transesophageal echocardiography (TEE) revealed a low echoic thrombus attached to the left atrial appendage. She was administered sufficient heparin to maintain activated partial thromboplastin time for 70-90 s. Forty-eight hours later when she was subject to surgical thrombectomy, the thrombus was found to have completely disappeared by TEE without further systemic embolization. This case provides information regarding variability of time for anticoagulation-related resolution of left atrial thrombus associated with atrial fibrillation.

摘要

我们报告了一例罕见的巨大左心房血栓病例，该血栓在开始抗凝治疗后很快消失，且无进一步系统性栓塞的证据。一名75岁非瓣膜性心房颤动女性突然抱怨右臂和左腿疼痛。增强计算机断层扫描显示右肱动脉和左腘动脉闭塞。经食管超声心动图（TEE）显示左心耳附着有低回声血栓。给予她足够的肝素以维持活化部分凝血活酶时间在70 - 90秒。48小时后，当她接受手术取栓时，TEE发现血栓已完全消失，且无进一步的系统性栓塞。该病例提供了与心房颤动相关的左心房血栓抗凝相关溶解时间变异性的信息。