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心脏瓣膜机械假体:完美匹配直到不再完美——一例报告

Heart valve mechanical prosthesis: The perfect match until it is not - A case report.

作者信息

Movileanu Ionela, Pepa Miruna, Cândea Marcela, Ureche Corina

机构信息

First Cardiology Department, Emergency Institute of Cardiovascular Diseases and Transplant, 540136 Târgu Mure?, Romania.

First Internal Medical Department, 'George Emil Palade' University of Medicine, Pharmacy, Sciences and Technology, 540136 Târgu Mure?, Romania.

出版信息

Exp Ther Med. 2020 Sep;20(3):2481-2483. doi: 10.3892/etm.2020.8959. Epub 2020 Jun 29.

Abstract

Primary immune thrombocytopenia (ITP), formerly known as idiopathic thrombocytopenia, is defined by a reduced platelet count <50x10 and is clinically manifested through signs and symptoms such as bleeding, ecchymosis and petechiae. Its coexistence with the implantation of the mechanical valves and the necessity of anticoagulation creates an additional risk of bleeding. Although mechanical valves are indispensable in prolonging and improving the quality of life in patients with valvular heart disease, in the context of an additional bleeding risk factor, their presence could represent a threat to life exposing the patient to major complications and leading to death. The purpose of this case report is to discuss the disadvantages and possible fatal complications of the association between mechanical valves and severe thrombocytopenia. A possible solution to these downsides could be found in the future search in regenerative medicine and tissue engineering of heart valves resulting in products that do not require anticoagulation and do not pose a threat to patients with thrombocytopenia.

摘要

原发性免疫性血小板减少症(ITP),以前称为特发性血小板减少症,定义为血小板计数减少<50x10⁹/L,临床表现为出血、瘀斑和瘀点等体征和症状。它与机械瓣膜植入并存以及抗凝的必要性增加了出血风险。尽管机械瓣膜对于延长和改善瓣膜性心脏病患者的生活质量不可或缺,但在存在额外出血风险因素的情况下,其存在可能对生命构成威胁,使患者面临重大并发症并导致死亡。本病例报告的目的是讨论机械瓣膜与严重血小板减少症关联的弊端及可能的致命并发症。未来在心脏瓣膜再生医学和组织工程领域的研究可能会找到解决这些弊端的办法,从而研发出无需抗凝且对血小板减少症患者无威胁的产品。

相似文献

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Antithrombotic Management of Patients With Prosthetic Heart Valves.人工心脏瓣膜患者的抗栓治疗管理
Cardiol Rev. 2018 Jul/Aug;26(4):177-186. doi: 10.1097/CRD.0000000000000189.
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本文引用的文献

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Immune thrombocytopenia: no longer 'idiopathic'.免疫性血小板减少症:不再是“特发性”。
Cleve Clin J Med. 2011 Jun;78(6):358-73. doi: 10.3949/ccjm.78gr.10005.

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