病例报告：一例继发于新型冠状病毒肺炎感染的经导管主动脉瓣置换术失败病例
Case report: a transcatheter aortic valve replacement failure secondary to COVID-19 infection.
作者信息
Tacon P Ryan, Cao Louie, Birkeland Kade, Kedan Ilan
机构信息
Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
Enterprise Data Intelligence, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
出版信息
Eur Heart J Case Rep. 2023 Jan 31;7(2):ytad054. doi: 10.1093/ehjcr/ytad054. eCollection 2023 Feb.
BACKGROUND
Valve thrombosis is a well-documented cause of bioprosthetic valve failure. Case reports have been published of prosthetic valve thrombosis secondary to COVID-19 infection. This is the first case report of COVID-19 associated valve thrombosis in a patient with transcatheter aortic valve replacement (TAVR).
CASE SUMMARY
A 90-year-old female with atrial fibrillation on therapeutic apixaban and status-post TAVR presented with COVID-19 infection and was found to have severe bioprosthetic valvular regurgitation with features suggestive of valve thrombosis. She underwent valve-in-valve TAVR with resolution of valvular dysfunction.
DISCUSSION
This case report contributes to a growing body of evidence describing the occurrence of thrombotic complications in patients with valve replacement and COVID-19 infection. Increased vigilance and continued investigation are warranted to better characterize thrombotic risk and to inform optimal antithrombotic strategies during COVID-19 infection.
背景
瓣膜血栓形成是生物人工瓣膜功能障碍的一个有充分文献记载的原因。已有关于继发于新型冠状病毒肺炎（COVID-19）感染的人工瓣膜血栓形成的病例报告发表。这是首例经导管主动脉瓣置换术（TAVR）患者中与COVID-19相关的瓣膜血栓形成的病例报告。
病例摘要
一名90岁女性，因心房颤动正在接受阿哌沙班治疗，且已接受TAVR手术，出现COVID-19感染，被发现存在严重的生物人工瓣膜反流，具有提示瓣膜血栓形成的特征。她接受了瓣中瓣TAVR手术，瓣膜功能障碍得到缓解。
讨论
本病例报告为越来越多描述瓣膜置换患者和COVID-19感染中血栓并发症发生情况的证据做出了贡献。需要提高警惕并持续进行研究，以更好地描述血栓形成风险，并为COVID-19感染期间的最佳抗血栓策略提供依据。
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