Izhakian Shimon, Korlansky Miriam, Rosengarten Dror, Bruckheimer Elchanan, Kramer Mordechai Reuven
Pulmonary Institute, Rabin Medical Center, Petach Tikva 49100, Israel.
Cardiac Catheterization Laboratory, Schneider Children's Medical Center, Petach Tikva 49100, Israel.
World J Clin Cases. 2025 Mar 26;13(9):96897. doi: 10.12998/wjcc.v13.i9.96897.
Alagille syndrome is a multisystem disease that results in various vascular anomalies, commonly involving the cardiac and pulmonary systems. To the best of our knowledge, there is no literature regarding the cardiovascular outcomes of these patients in association with coronavirus disease 2019 (COVID-19).
A 34-year-old woman with a history of Alagille syndrome who underwent successful atrial septal defect with partial anomalous pulmonary veins and patent ductus arteriosus repair, as well as left pulmonary artery catheterization and stenting in childhood due to pulmonary stenosis. The patient was without any respiratory symptoms and was a dancer prior to contracting COVID-19. Several weeks after her COVID-19 infection, she developed left pulmonary artery stent thrombosis and subsequent symptomatic pulmonary hypertension. A treatment strategy of anticoagulation alongside pharmacological agents for pulmonary hypertension for 3 months followed by balloon pulmonary artery angioplasty to reopen the stenosis was unsuccessful.
In the era of COVID-19, patients with pulmonary vascular malformations and endovascular stents are at an increased risk for chronic thromboembolic disease. Patients may benefit from prophylactic antiplatelet or anticoagulation therapy. Stent thrombosis is a devastating phenomenon and should be treated urgently and aggressively with balloon pulmonary angioplasty, and/or a thrombolytic agent.
阿拉吉列综合征是一种多系统疾病，可导致各种血管异常，常见于心脏和肺部系统。据我们所知，尚无关于这些患者与2019冠状病毒病（COVID-19）相关的心血管结局的文献。
一名34岁患有阿拉吉列综合征的女性，童年时因肺动脉狭窄成功接受了房间隔缺损伴部分肺静脉异常和动脉导管未闭修复术，以及左肺动脉导管插入术和支架置入术。该患者在感染COVID-19之前没有任何呼吸道症状，是一名舞蹈演员。在感染COVID-19几周后，她出现了左肺动脉支架血栓形成，随后出现有症状的肺动脉高压。采用抗凝联合治疗肺动脉高压的药物治疗3个月，随后进行球囊肺动脉血管成形术以重新开通狭窄的治疗策略未成功。
在COVID-19时代，患有肺血管畸形和血管内支架的患者发生慢性血栓栓塞性疾病的风险增加。患者可能从预防性抗血小板或抗凝治疗中获益。支架血栓形成是一种毁灭性现象，应紧急且积极地采用球囊肺动脉血管成形术和/或溶栓剂进行治疗。
