Alam Amit, Doshi Harsh, Patel Divya N, Patel Keval, James Dreamy, Almendral Jesus
Division of Advanced Heart Failure, Baylor University Medical Center, Dallas, Texas.
Department of Cardiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
Proc (Bayl Univ Med Cent). 2021 Sep 15;35(1):93-95. doi: 10.1080/08998280.2021.1973285. eCollection 2022.
An association has been reported between factor VIII and arterial thrombosis such as ischemic stroke and myocardial infarction. We report a 36-year-old man who had a myocardial infarction despite lacking traditional cardiac risk factors. He developed end-stage heart failure and renal insufficiency necessitating a HeartMate II left ventricular assist device (LVAD). While on the transplant list, he experienced two episodes of LVAD thrombosis 6 months apart, prompting device exchange and escalation of anticoagulation therapy. He eventually underwent a successful heart-kidney transplant before suffering an extensive left lower extremity deep vein thrombosis 6 weeks later. A thrombophilia workup revealed elevated factor VIII activity of 319% (normal range, 50%-150%). He was placed on indefinite anticoagulation with apixaban with no further thrombotic episode in 18 months of follow-up to date.
已有报道称因子VIII与动脉血栓形成有关，如缺血性中风和心肌梗死。我们报告一名36岁男性，他虽无传统心脏危险因素却发生了心肌梗死。他发展为终末期心力衰竭和肾功能不全，需要植入HeartMate II左心室辅助装置（LVAD）。在等待移植期间，他相隔6个月发生了两次LVAD血栓形成事件，促使进行装置更换并加强抗凝治疗。他最终成功接受了心脏-肾脏移植，然而6周后又发生了广泛的左下肢深静脉血栓形成。血栓形成倾向检查显示因子VIII活性升高至319%（正常范围为50%-150%）。他开始使用阿哌沙班进行长期抗凝治疗，截至目前的18个月随访中未再发生血栓形成事件。
