经皮腔内血管成形术联合脑栓子保护装置治疗开窗Fontan导管巨大血栓形成：一例报告
Percutaneous rheolytic thrombectomy and cerebral embolic protection in a massive thrombosis of a fenestrated Fontan conduit: a case report.
作者信息
Marzullo Raffaella, Capestro Alessandro, Muçaj Andi, Piva Tommaso
机构信息
Pediatric Cardiology, University of Campania 'Luigi Vanvitelli', Former Second University of Naples, Monaldi Hospital-AORN Ospedali dei Colli, Via Leonardo Bianchi 1, Naples 80131, Italy.
Department of Pediatric and Congenital Cardiac Surgery and Cardiology, Azienda Ospedaliero-Universitaria-Ospedali Riuniti Ancona 'Umberto I-G.M.Lancisi-G.Salesi', Ancona, Italy.
出版信息
Eur Heart J Case Rep. 2023 May 9;7(5):ytad238. doi: 10.1093/ehjcr/ytad238. eCollection 2023 May.
BACKGROUND
Clinical thromboembolism in Fontan patients is often a catastrophic event resulting in death and adverse long-term outcomes. The treatment of acute thromboembolic complications in these patients is very controversial.
CASE SUMMARY
We describe the use of rheolytic thrombectomy in a Fontan patient with life-threatening pulmonary embolism, employing a cerebral protection system to reduce the risk of stroke through the fenestration.
DISCUSSION
Rheolytic thrombectomy may be a successful alternative to systemic thrombolytic therapy and open surgical resection for the treatment of acute high-risk pulmonary embolism in the Fontan population. Embolic protection device to capture and remove thrombus/debris may be an innovative tool to reduce the risk of stroke through the fenestration while performing a percutaneous procedure in fenestrated Fontan patient.
背景
Fontan 患者的临床血栓栓塞通常是灾难性事件，会导致死亡和不良的长期预后。这些患者急性血栓栓塞并发症的治疗极具争议性。
病例摘要
我们描述了在一名患有危及生命的肺栓塞的 Fontan 患者中使用血栓消融术，采用脑保护系统以降低通过开窗导致中风的风险。
讨论
血栓消融术可能是 Fontan 人群中治疗急性高危肺栓塞的一种成功替代全身溶栓治疗和开放性手术切除的方法。用于捕获和清除血栓/碎片的栓子保护装置可能是一种创新工具，可在为有开窗的 Fontan 患者进行经皮手术时降低通过开窗导致中风的风险。
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