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1例Löffler心内膜炎的血栓切除术病例

A Case of Thrombectomy for Loeffler's Endocarditis.

作者信息

Kimura Takanobu, Takeuchi Akira, Nakamura Takeru, Tamaoka Koki, Tsuneyoshi Hiroshi

机构信息

Department of Cardiovascular Surgery, Shizuoka General Hospital, Shizuoka, JPN.

出版信息

Cureus. 2024 Jul 12;16(7):e64384. doi: 10.7759/cureus.64384. eCollection 2024 Jul.

DOI:10.7759/cureus.64384
PMID:39130964
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11317017/
Abstract

Loeffler's endocarditis, characterized by eosinophilic infiltration leading to thrombus formation and fibrosis in the ventricle, is associated with severe complications, such as embolism and heart failure. While anticoagulation and steroids are standard treatments, surgical thrombectomy is rarely reported. This is a case report of a 74-year-old man presented with an abnormal electrocardiogram. Echocardiography revealed a 38 × 29 mm mass in the left ventricular apex, and blood studies revealed hypereosinophilia, leading to a diagnosis of Loeffler's endocarditis. Despite warfarin treatment, the thrombus persisted. The left ventricular intracardiac thrombus exhibited significant mobility, and we decided to perform a thrombectomy via a trans-left ventricular approach. After the surgery, steroid therapy was initiated. The patient recovered without recurrence of the thrombus or deterioration in cardiac function. Left ventricular thrombectomy for Loeffler's endocarditis is considered a beneficial option to prevent thrombosis.

摘要

吕弗勒心内膜炎的特征是嗜酸性粒细胞浸润导致心室血栓形成和纤维化，与严重并发症相关，如栓塞和心力衰竭。虽然抗凝和类固醇是标准治疗方法，但手术取栓术鲜有报道。本文报告一例74岁男性患者，其心电图异常。超声心动图显示左心室心尖部有一个38×29mm的肿块，血液检查显示嗜酸性粒细胞增多，诊断为吕弗勒心内膜炎。尽管使用了华法林治疗，血栓仍然存在。左心室内血栓具有显著的活动性，我们决定通过经左心室途径进行取栓术。术后开始使用类固醇治疗。患者康复，血栓未复发，心功能也未恶化。对于吕弗勒心内膜炎，左心室取栓术被认为是预防血栓形成的有益选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed6e/11317017/0c4ee817763e/cureus-0016-00000064384-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed6e/11317017/14c8d0548444/cureus-0016-00000064384-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed6e/11317017/4387939ee951/cureus-0016-00000064384-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed6e/11317017/334491568080/cureus-0016-00000064384-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed6e/11317017/0c4ee817763e/cureus-0016-00000064384-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed6e/11317017/14c8d0548444/cureus-0016-00000064384-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed6e/11317017/4387939ee951/cureus-0016-00000064384-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed6e/11317017/334491568080/cureus-0016-00000064384-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed6e/11317017/0c4ee817763e/cureus-0016-00000064384-i04.jpg

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本文引用的文献

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Loeffler endocarditis with intracardiac thrombus: case report and literature review.Loeffler 心内膜炎合并心内血栓：病例报告及文献复习。
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Loeffler endocarditis: silent right ventricular myocardium!吕弗勒心内膜炎：隐匿的右心室心肌！
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[Multiple cerebral infarctions in a patient with hypereosinophilic syndrome with Löffler endocarditis: a case report].[嗜酸性粒细胞增多综合征合并吕弗勒心内膜炎患者的多发性脑梗死：一例报告]
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