Kumagai Motoyuki, Takehara Makoto, Nishizawa Junichiro
Department of Cardiovascular Surgery, Hamamatsu Rosai Hospital, Hamamatsu, Japan.
Kyobu Geka. 2020 Feb;73(2):135-137.
A 52-year-old woman with mitral valve insufficiency and congestive heart failure due to infective endocarditis was treated by mitral valve replacement with a mechanical valve. Warfarin was started on postoperative day (POD) 3, but sudden onset of anemia with left abdominal pain presented on POD 8. Abdominal apoplexy was diagnosed by computed tomography (CT) and ultrasonographic imaging, but active bleeding was not evident. She was hemodynamically stable and her prothrombin time-international normalized ratio(PT-INR) at that time was 1.70 (compared with 2.56 on POD 7). To avoid repeated bleeding, PT-INR was controlled at around 1.5. Other complications did not arise, and thereafter her postoperative course was favorable.
一名52岁女性因感染性心内膜炎导致二尖瓣关闭不全和充血性心力衰竭，接受了二尖瓣机械瓣置换术。术后第3天开始使用华法林，但术后第8天突然出现贫血并伴有左腹痛。通过计算机断层扫描（CT）和超声成像诊断为腹部卒中，但未发现活动性出血。她血流动力学稳定，当时的凝血酶原时间-国际标准化比值（PT-INR）为1.70（与术后第7天的2.56相比）。为避免再次出血，将PT-INR控制在1.5左右。未出现其他并发症，此后她的术后恢复过程顺利。
