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抗磷脂综合征与心脏瓣膜病:血栓事件的复杂情况,病例报告。

Antiphospholipid syndrome and valvular heart disease, a complex scenario of thrombotic events, a case report.

机构信息

Department of Surgery Division of Cardiothoracic Surgery, Hospital Metropolitano, Av. Mariana de Jesús Oe7/47 y Conclina, Edificio Diagnóstico 2000 tercer piso 3/3, Quito, Ecuador.

Department of Internal Medicine Division of Cardiology, Hospital Metropolitano, Quito, Ecuador.

出版信息

J Cardiothorac Surg. 2020 Sep 29;15(1):275. doi: 10.1186/s13019-020-01330-9.

Abstract

BACKGROUND

Antiphospholipid syndrome (APS) is a rare coagulation disorder associated with thrombotic events, myocardial infarction, and valvular heart disease. During valvular replacement surgery, the high risk of thrombosis combined with the operative risks in these specific groups of patients poses a challenge to the medical team.

CASE PRESENTATION

We present a case of a female patient with APS and mixed aortic valve disease. During surgery, she suddenly developed complete cardiac arrest. Three months later, after she recovered, and while she was still on close follow up, a thrombotic event caused myocardial infarction. After prompt and precise treatment, the patient successfully recovered; one year after surgery patient is doing well.

CONCLUSION

Adequate surgical technique along with optimal anticoagulation strategies and long term follow up are of paramount importance to ensure an uneventful recovery. A multidisciplinary team is required to manage these complex scenarios and high-risk patients.

摘要

背景

抗磷脂综合征(APS)是一种罕见的与血栓事件、心肌梗死和心脏瓣膜病相关的凝血障碍。在心脏瓣膜置换手术中,高血栓风险与这些特定患者群体的手术风险相结合,给医疗团队带来了挑战。

病例介绍

我们报告了一例 APS 合并混合性主动脉瓣疾病的女性患者。手术过程中,她突然出现完全心脏骤停。三个月后,在她康复并仍在密切随访期间,血栓事件导致心肌梗死。经过及时准确的治疗,患者成功康复;手术后一年,患者情况良好。

结论

充分的手术技术以及最佳的抗凝策略和长期随访对于确保顺利康复至关重要。需要多学科团队来管理这些复杂的情况和高危患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e9c/7526220/5c2cc0a890ff/13019_2020_1330_Fig1_HTML.jpg

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