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达比加群抗凝治疗后经皮左心耳封堵患者的封堵装置相关血栓形成:病例报告与文献综述

Closure Device-Related Thrombosis After Anticoagulation With Dabigatran in Patients Undergoing Percutaneous Left Atrial Appendage Closure: Case Reports and Literature Review.

作者信息

Li Xiaoye, Jin Qinchun, Zhang Xiaochun

机构信息

Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, China.

Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China.

出版信息

Front Pharmacol. 2020 Sep 8;11:563920. doi: 10.3389/fphar.2020.563920. eCollection 2020.

Abstract

Percutaneous left atrial appendage closure (LAAC) is an effective and safe operation strategy for stroke prevention in patients who are diagnosed with atrial fibrillation (AF) but cannot tolerate long term anticoagulation medication. We presented four rare cases of thrombosis formation on the occluder device. After the LAAC operation was successfully performed on patients, they followed a course of anticoagulation with dabigatran (110 mg b.i.d.), and device-related thrombosis (DRT) occurred as indicated by a transesophageal echocardiogram (TEE) during the follow-up period. Regressions were achieved after replacing dabigatran with rivaroxaban or warfarin for more than 1 month. No thrombosis or bleeding-related complications occurred in subsequent follow-ups.

摘要

经皮左心耳封堵术(LAAC)是诊断为心房颤动(AF)但无法耐受长期抗凝药物治疗的患者预防中风的一种有效且安全的手术策略。我们报告了4例封堵器上形成血栓的罕见病例。患者成功接受LAAC手术后,接受达比加群(110 mg,每日两次)抗凝治疗,随访期间经食管超声心动图(TEE)显示发生了与器械相关的血栓形成(DRT)。在将达比加群替换为利伐沙班或华法林治疗1个月以上后,血栓消退。后续随访未发生血栓形成或出血相关并发症。

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