病例报告：尽管进行了有效的抗凝治疗，但在新冠病毒肺炎（COVID-19）背景下发生机械二尖瓣人工瓣膜血栓形成。
Case report: Mechanical mitral prosthetic valve thrombosis in the context of COVID-19 despite effective anticoagulation.
作者信息
Jeckelmann Clarisse, Djokic Bojan, Duchatelle Valérie, Girod Grégoire
机构信息
Faculty of Biology and Medicine, University of Lausanne, UNIL-BUGNON, 1011 Lausanne, VD, CH, Switzerland.
Department of Cardiology, Hôpital du Valais Romand, Sion, VS, CH, Switzerland.
出版信息
Eur Heart J Case Rep. 2022 Jan 24;6(2):ytac006. doi: 10.1093/ehjcr/ytac006. eCollection 2022 Feb.
BACKGROUND
The SARS-CoV2 virus has been an emerging virus since December 2019 and is the cause of a global pandemic whose clinical manifestations extend far beyond respiratory disease.
CASE SUMMARY
A patient with severe coronavirus disease 2019 respiratory infection, carrying a mechanical mitral valve and under anticoagulation, was admitted to our cardiology department because of a new atrial fibrillation, which turned out to be related to thrombosis of the mitral mechanical valve.
CONCLUSION
The pro-coagulant effect of the SARS-CoV2 virus does not spare patients at risk of thrombosis, even under effective anticoagulation. In patients with mechanical valves under vitamin K antagonist treatment, there is a high risk of thrombus formation. The treatment is based on thrombolysis by therapeutic anticoagulation, fibrinolysis, or surgery depending on the size, composition of thrombus, and clinical manifestation.
背景
自2019年12月以来，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）一直是一种新出现的病毒，它是一场全球大流行疾病的病原体，其临床表现远远超出呼吸道疾病范畴。
病例摘要
一名患有2019冠状病毒病严重呼吸道感染、携带机械二尖瓣且正在接受抗凝治疗的患者，因新发心房颤动入住我们的心脏病科，结果发现这与二尖瓣机械瓣血栓形成有关。
结论
SARS-CoV-2病毒的促凝作用不放过有血栓形成风险的患者，即使在有效的抗凝治疗下也是如此。在接受维生素K拮抗剂治疗的机械瓣患者中，血栓形成风险很高。治疗方法根据血栓大小、成分和临床表现，基于治疗性抗凝、纤维蛋白溶解或手术进行溶栓。
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