Graver L M, Gelber P M, Tyras D H
Division of Cardiothoracic Surgery, Long Island Jewish Medical Center, New Hyde Park, NY 11042.
Ann Thorac Surg. 1988 Jul;46(1):85-8. doi: 10.1016/s0003-4975(10)65859-6.
A patient with acute thrombosis of a St. Jude mitral prosthesis was treated with streptokinase with initial success. Subsequent recurrent thrombosis and embolism prompted operative revision. Because the use of thrombolytic agents in this setting is somewhat controversial, we searched the literature for all reports of aortic or mitral prosthetic valve dysfunction treated this way. The cases of 58 patients treated 62 times were reviewed for efficacy of therapy and morbidity. Thrombolytic therapy may be useful in patients with prosthetic valve thrombosis causing critical hemodynamic compromise. It is frequently the only treatment needed. Further, it may help reduce operative risk for those patients in whom complete resolution is not possible. The incidence of systemic embolism is 18%, however, neurological events are usually limited and transient.
一名植入圣犹达二尖瓣人工瓣膜后发生急性血栓形成的患者接受了链激酶治疗，初期取得成功。随后的复发性血栓形成和栓塞促使进行手术翻修。由于在这种情况下使用溶栓剂存在一定争议，我们检索了文献中所有以这种方式治疗主动脉或二尖瓣人工瓣膜功能障碍的报告。对58例患者接受62次治疗的病例进行了疗效和发病率评估。溶栓治疗对于因人工瓣膜血栓形成导致严重血流动力学损害的患者可能有用。它常常是唯一所需的治疗方法。此外，对于那些无法实现完全溶解的患者，它可能有助于降低手术风险。然而，全身性栓塞的发生率为18%，神经系统事件通常有限且短暂。
