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新冠病毒肺炎合并巨大三尖瓣赘生物。

Large tricuspid valve thrombus complicating COVID-19 pneumonia.

机构信息

Department of Cardiothoracic Surgery, Faculty of Medicine, Minia University, El-Minya, Egypt.

出版信息

J Card Surg. 2022 Oct;37(10):3417-3420. doi: 10.1111/jocs.16761. Epub 2022 Jul 16.

Abstract

BACKGROUND

Hemostatic disturbances with coronavirus disease 2019 (COVID-19) can predispose to tricuspid and right heart thrombi in very rare instances.

AIM

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.

MATERIALS AND METHODS

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.

DISCUSSION AND CONCLUSION

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.

摘要

背景

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。

目的

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。

材料和方法

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。

讨论和结论

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。

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