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人工二尖瓣血栓形成与出血性中风的灾难性关联。

The catastrophic association of prosthetic mitral valve thrombosis and hemorrhagic stroke.

作者信息

Morais Humberto, Gonçalves Mauer A A

机构信息

Centro de Estudos Avançados em Educação e Formação Médica, Faculdade de Medicina da Universidade Agostinho Neto, Luanda, Angola.

Departamento de Cardiologia. Hospital Militar Principal/Instituto Superior, Luanda, Angola.

出版信息

Glob Cardiol Sci Pract. 2023 Sep 30;2023(4):e202331. doi: 10.21542/gcsp.2023.31.

DOI:10.21542/gcsp.2023.31
PMID:38404630
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10886791/
Abstract

Prosthetic valve thrombosis is a serious complication of valve replacement associated with a high mortality rate. Stroke may be the first symptom of prosthetic valve thrombosis. We present the case of a patient who visited the emergency department with symptoms of dysarthria and left hemiparesis. An examination revealed an ischemic stroke with hemorrhagic transformation, stemming from a thrombosis of their mitral valve prosthesis, which progressed to the patient's death. We emphasize the difficulty in the therapeutic and diagnostic management of these patients.

摘要

人工瓣膜血栓形成是瓣膜置换术的一种严重并发症,死亡率很高。中风可能是人工瓣膜血栓形成的首发症状。我们报告一例患者,该患者因构音障碍和左侧偏瘫症状前往急诊科就诊。检查发现为缺血性中风伴出血性转化,起因于其二尖瓣人工瓣膜血栓形成,最终患者死亡。我们强调这些患者在治疗和诊断管理方面存在困难。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3af1/10886791/18452624eb9d/gcsp-2023-4-e202331-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3af1/10886791/a7bf3bd9cd23/gcsp-2023-4-e202331-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3af1/10886791/72faa71495d9/gcsp-2023-4-e202331-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3af1/10886791/b243bda46c74/gcsp-2023-4-e202331-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3af1/10886791/18452624eb9d/gcsp-2023-4-e202331-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3af1/10886791/a7bf3bd9cd23/gcsp-2023-4-e202331-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3af1/10886791/72faa71495d9/gcsp-2023-4-e202331-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3af1/10886791/b243bda46c74/gcsp-2023-4-e202331-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3af1/10886791/18452624eb9d/gcsp-2023-4-e202331-g004.jpg

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本文引用的文献

1
ACC/AHA Versus ESC Guidelines on Prosthetic Heart Valve Management: JACC Guideline Comparison.美国心脏病学会/美国心脏协会与欧洲心脏病学会关于人工心脏瓣膜管理的指南比较:美国心脏病学会指南比较。
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Prosthetic Valve Thrombosis in the Acute Phase of the Stroke: Relevance of Detection and Follow-Up.卒中急性期人工瓣膜血栓形成:检测与随访的相关性
J Stroke Cerebrovasc Dis. 2017 May;26(5):1110-1113. doi: 10.1016/j.jstrokecerebrovasdis.2016.12.028. Epub 2017 Jan 13.
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A global perspective on mechanical prosthetic heart valve thrombosis: Diagnostic and therapeutic challenges.
机械人工心脏瓣膜血栓形成的全球视角:诊断与治疗挑战
Anatol J Cardiol. 2016 Dec;16(12):980-989. doi: 10.14744/AnatolJCardiol.2016.7486.
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Nonobstructive mechanical prosthetic valve thrombosis with acute stroke.非阻塞性机械人工瓣膜血栓形成伴急性卒中
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Diagnostic assessment of prosthetic mitral valve thrombosis by real-time three-dimensional transoesophageal echocardiography and successful thrombolytic treatment.实时三维经食管超声心动图对人工二尖瓣血栓形成的诊断评估及成功的溶栓治疗
Cardiovasc J Afr. 2011 Nov-Dec;22(6):340-2. doi: 10.5830/cvja-2010-071.
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Diagnosis and treatment of left-sided prosthetic valve thrombosis.左侧人工瓣膜血栓形成的诊断与治疗
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7
Thrombosis of prosthetic heart valves: diagnosis and therapeutic considerations.人工心脏瓣膜血栓形成:诊断与治疗考量
Heart. 2007 Jan;93(1):137-42. doi: 10.1136/hrt.2005.071183.
8
Prosthetic heart valve thrombosis: pathogenesis, diagnosis and management.人工心脏瓣膜血栓形成:发病机制、诊断与管理
Int J Cardiol. 2006 Jun 7;110(1):1-6. doi: 10.1016/j.ijcard.2005.06.051. Epub 2005 Jul 20.
9
Late incidence and determinants of stroke after aortic and mitral valve replacement.主动脉瓣和二尖瓣置换术后卒中的晚期发生率及决定因素
Ann Thorac Surg. 2004 Jul;78(1):77-83; discussion 83-4. doi: 10.1016/j.athoracsur.2003.12.058.