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经皮左心耳封堵术治疗与抗凝治疗和心房颤动相关弥漫性肺泡出血患者。

Percutaneous Left Atrial Appendage Closure in a Patient with Diffuse Alveolar Hemorrhaging Associated with Anticoagulant Therapy and Atrial Fibrillation.

机构信息

Department of Respiratory, Kokura Memorial Hospital, Japan.

Department of Cardiovascular Medicine, Kokura Memorial Hospital, Japan.

出版信息

Intern Med. 2022 Jul 1;61(13):2045-2050. doi: 10.2169/internalmedicine.8551-21. Epub 2021 Nov 27.

Abstract

Diffuse alveolar hemorrhaging (DAH) due to oral anticoagulation (OAC) is a life-threatening condition that leads to severe respiratory failure. There is a clinical dilemma in that OAC-induced DAH often forces the discontinuation of OAC therapy and the administration of high-dose corticosteroids, which increases the risk of stroke and cardiovascular events. We herein report the first case of OAC-induced DAH and atrial fibrillation (AF) in a patient who completely discontinued OAC therapy and high-dose corticosteroids after experiencing percutaneous left atrial appendage (LAA) occlusion. This case suggests that percutaneous LAA closure may aid in the management of OAC-induced DAH and AF.

摘要

弥漫性肺泡出血(DAH)是由口服抗凝剂(OAC)引起的,可导致严重的呼吸衰竭,是一种危及生命的病症。存在一个临床难题,即 OAC 引起的 DAH 常迫使停止 OAC 治疗并给予大剂量皮质类固醇,这会增加中风和心血管事件的风险。我们在此报告首例因接受经皮左心耳(LAA)封堵术而完全停止 OAC 治疗和大剂量皮质类固醇治疗的 OAC 诱导的 DAH 和心房颤动(AF)的患者。该病例表明,经皮 LAA 封堵术可能有助于 OAC 诱导的 DAH 和 AF 的治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d961/9334249/f41da9151fc0/1349-7235-61-2045-g001.jpg

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