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医源性右心房血栓合并肺栓塞的管理和结局。

Iatrogenic Right Atrial Thrombus Complicated by Pulmonary Embolism: Management and Outcomes.

机构信息

Department of Internal Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA 01107, United States.

Overland Park Regional Medical Center-HCA Midwest Health, Overland Park, KS 66215, United States.

出版信息

Curr Cardiol Rev. 2021;17(4):e230421188336. doi: 10.2174/1573403X16999201124201632.

Abstract

Right atrial thrombus can originate from distal venous sources or can be iatrogenic, secondary to the placement of central venous catheters, atrial devices, or surgeries. One of the most common complications of Central Venous Catheters (CVCs) is thromboembolism, which can be either fixed to the right atrium or can be free-floating. Device-related Right Atrial Thrombosis (RAT) can result in catheter occlusion, vascular occlusion, infection, and pulmonary embolism. The true incidence of these complications is unknown because the diagnosis may not be considered in asymptomatic patients, and it might be missed by Transthoracic Echocardiography (TTE). In this literature review, we discuss iatrogenic etiologies of RAT that is complicated by pulmonary embolism. We highlight the importance of maintaining a high index of suspicion of iatrogenic RAT, possible complications, and its management.

摘要

右心房血栓可源自远端静脉源,也可由医源性因素引起,如放置中心静脉导管、心房装置或手术。中心静脉导管(CVC)最常见的并发症之一是血栓栓塞,可固定于右心房,也可游离。与器械相关的右心房血栓(RAT)可导致导管阻塞、血管阻塞、感染和肺栓塞。这些并发症的真实发生率尚不清楚,因为无症状患者可能不会考虑诊断,经胸超声心动图(TTE)也可能漏诊。在本次文献回顾中,我们讨论了 RAT 的医源性病因,其并发肺栓塞。我们强调了对医源性 RAT 及其可能的并发症保持高度怀疑并进行管理的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8070/8762153/fddb12d78a12/CCR-17-e230421188336_F1.jpg

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