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机械心脏瓣膜置换术后接受腹腔镜胆囊切除术患者围手术期抗凝管理:一例术后脑栓塞病例报告

Management of perioperative anticoagulation in patients with mechanical heart valve replacement undergoing laparoscopic cholecystectomy: a case report of postoperative cerebral embolism.

作者信息

He Wei, Tang Panli

机构信息

Department of Ophthalmology, Sichuan Taikang Hospital, Chengdu, China.

Department of Cardiothoracic Surgery, Sichuan Taikang Hospital, Chengdu, China.

出版信息

Front Surg. 2024 Aug 21;11:1404436. doi: 10.3389/fsurg.2024.1404436. eCollection 2024.

Abstract

Patients with mechanical heart valve replacement require lifelong anticoagulation therapy, and additional surgeries can pose a risk of bleeding and thromboembolic events due to the need for perioperative anticoagulation management. Here, we present a case report of a patient who underwent laparoscopic cholecystectomy (LC) and endoscopic retrograde cholangiopancreatography (ERCP) after mechanical heart valve replacement and experienced postoperative cerebral embolism. The management of perioperative anticoagulation in these patients is discussed, including strategies for minimizing the risks of bleeding and thromboembolic events during and after surgery.

摘要

接受机械心脏瓣膜置换术的患者需要终身抗凝治疗,由于围手术期抗凝管理的需要,额外的手术可能会带来出血和血栓栓塞事件的风险。在此,我们报告一例患者,该患者在接受机械心脏瓣膜置换术后接受了腹腔镜胆囊切除术(LC)和内镜逆行胰胆管造影术(ERCP),并发生了术后脑栓塞。讨论了这些患者围手术期抗凝的管理,包括在手术期间和术后将出血和血栓栓塞事件风险降至最低的策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43b1/11371760/2ea6a101f31a/fsurg-11-1404436-g001.jpg

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