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肺栓塞合并右心室血栓后发生慢性血栓栓塞性肺动脉高压:两例报告

Chronic thromboembolic pulmonary hypertension following pulmonary embolism with a right ventricular thrombus: A report of two cases.

作者信息

Zhang Tailong, Liang Weitao, Bian Longrong, Wu Zhong

机构信息

Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, PR China.

出版信息

Pulm Circ. 2021 May 13;11(2):20458940211013668. doi: 10.1177/20458940211013668. eCollection 2021 Apr-Jun.

Abstract

Right heart thrombus accompanied by chronic thromboembolic pulmonary hypertension is a rare entity. Right heart thrombus may develop in the peripheral veins or in situ within the right heart chambers. The diagnosis of right heart thrombus is challenging, since its symptoms are typically non-specific and its imaging features resemble those of cardiac masses. Here, we report two cases of right heart thrombus with chronic thromboembolic pulmonary hypertension that presented as right ventricular masses initially. Both patients underwent simultaneous pulmonary endarterectomy and resection of the ventricular thrombi. Thus, when mass-like features are confirmed by imaging, right heart thrombus should be suspected in patients with chronic thromboembolic pulmonary hypertension, and simultaneous right heart thrombus resection is required along with pulmonary endarterectomy.

摘要

伴有慢性血栓栓塞性肺动脉高压的右心血栓是一种罕见的病症。右心血栓可能在外周静脉形成,也可能在右心腔内原位形成。右心血栓的诊断具有挑战性,因为其症状通常不具有特异性,且其影像学特征与心脏肿物相似。在此,我们报告两例伴有慢性血栓栓塞性肺动脉高压的右心血栓病例,最初均表现为右心室肿物。两名患者均同时接受了肺动脉内膜剥脱术和心室血栓切除术。因此,当影像学检查证实有肿物样特征时,对于患有慢性血栓栓塞性肺动脉高压的患者应怀疑右心血栓,并在进行肺动脉内膜剥脱术的同时需要切除右心血栓。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1dcb/8127759/d83ceb9fd876/10.1177_20458940211013668-fig1.jpg

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