比伐卢定作为全身性抗凝剂和冲洗液添加剂，用于伴有肝素诱导血小板减少症的患者的二尖瓣和三尖瓣经皮缘对缘修复术。
Bivalirudin as a Systemic Anticoagulant and Flush Solution Additive for Sequential Mitral and Tricuspid Valve Percutaneous Edge-to-Edge Repair in a Patient With Heparin-Induced Thrombocytopenia.
机构信息
Division of Cardiothoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL.
Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL.
出版信息
J Cardiothorac Vasc Anesth. 2022 Jun;36(6):1709-1714. doi: 10.1053/j.jvca.2021.03.004. Epub 2021 Mar 6.
Herein the case of a patient with a prior history of heparin-induced thrombocytopenia who underwent percutaneous mitral valve edge-to-edge repair that was followed by a tricuspid edge-to-edge repair two months later is presented. Recommendations exist for systemic anticoagulant alternatives for percutaneous mitral valve edge-to-edge repair with the MitraClip device (Abbott, Chicago, IL), but minimal guidance and experience are present regarding alternative systemic anticoagulation during the performance of right-sided interventions, including tricuspid edge-to-edge repair (TriClip; Abbott). Notably, there is no clear consensus regarding the use of an alternative anticoagulant in the catheter flush solution for the delivery systems used during these procedures, particularly for right-sided interventions.
现介绍 1 例既往有肝素诱导血小板减少症病史的患者，其在 2 个月后接受了经皮二尖瓣瓣环成形术，随后又进行了三尖瓣瓣环成形术。对于使用 MitraClip 装置（雅培，芝加哥，IL）进行经皮二尖瓣瓣环成形术，存在推荐的系统抗凝替代方案，但在进行右侧介入治疗（包括三尖瓣瓣环成形术 TriClip；雅培）时，替代全身抗凝的方法几乎没有指导和经验。值得注意的是，对于这些手术过程中使用的输送系统，在导管冲洗液中使用替代抗凝剂，特别是在右侧介入治疗中，尚无明确共识。
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