Department of Cardiothoracic Surgery, Faculty of Medicine, Minia University, El-Minya, Egypt.
J Card Surg. 2022 Oct;37(10):3417-3420. doi: 10.1111/jocs.16761. Epub 2022 Jul 16.
Hemostatic disturbances with coronavirus disease 2019 (COVID-19) can predispose to tricuspid and right heart thrombi in very rare instances.
We describe a 29-year-old female patient without a previous cause of thrombosis who developed large tricuspid valve thrombus (TVT) and moderate-to-severe tricuspid regurgitation (TR) during the course of COVID-19 infection.
Persistant fever and tachycardia with thrombocytopenia and high d-dimer increased the index of suspicion. The diagnosis was made by bedside transthoracic echocardiography (TTE) and cardiac magnetic resonance (CMR). Surgery was performed for thrombectomy and tricuspid valve replacement with a tissue valve.
Detection of TVT in COVID-19 patients on the basis of high index of suspicion, bedside TTE and noninvasive CMR helps early surgical treatment and subsequent reduction of mortality and hospital stay.
COVID-19 会引起止血功能紊乱，极罕见情况下可导致三尖瓣和右心血栓。
我们描述了一例 29 岁女性患者，在 COVID-19 感染过程中发生了大型三尖瓣血栓（TVT）和中重度三尖瓣反流（TR），此前无任何血栓形成的原因。
持续性发热、心动过速、血小板减少和 D-二聚体升高增加了怀疑指数。诊断通过床旁经胸超声心动图（TTE）和心脏磁共振（CMR）得出。手术采用血栓切除术和组织瓣三尖瓣置换术。
根据高度怀疑、床旁 TTE 和非侵入性 CMR 检测 COVID-19 患者的 TVT 有助于早期手术治疗，从而降低死亡率和住院时间。
