经皮机械抽吸导致心肌梗死的主动脉根部血栓
Percutaneous Mechanical Aspiration of an Aortic Root Thrombus Causing a Myocardial Infarction.
作者信息
Umadat Goyal, Lugo-Fagundo Nahyr, Landolfo Carolyn, Pollak Peter, El Sabbagh Abdallah
机构信息
Department of Cardiovascular Diseases, Mayo Clinic Florida, Jacksonville, Florida, USA.
Department of Cardiovascular Diseases, Mayo Clinic Florida, Jacksonville, Florida, USA.
出版信息
JACC Case Rep. 2025 May 28;30(12):103524. doi: 10.1016/j.jaccas.2025.103524. Epub 2025 Apr 23.
BACKGROUND
Left ventricular assist devices (LVADs) are critical for patients with end-stage cardiomyopathy but complications, such as aortic root thrombus (ART), are present in up to 10% of cases. ART management is challenging, with limited therapeutic options.
CASE SUMMARY
A 54-year-old female with an LVAD presented with acute chest pain and a thrombus in the left coronary cusp. She was treated with successful percutaneous mechanical aspiration (PMA) of the aortic root and coronary arteries. Her international normalized ratio target was increased, and she has not had a recurrence of her ART.
DISCUSSION
ART in LVAD patients often arises from impaired aortic valve opening, promoting thrombus formation. This case demonstrates the utility of PMA as a safe and effective alternative to surgical removal.
TAKE-HOME MESSAGES: ART is a critical complication of LVADs, requiring prompt diagnosis and treatment. PMA can offer a definitive and safe treatment option for ART in select patients.
背景
左心室辅助装置（LVAD）对终末期心肌病患者至关重要，但并发症如主动脉根部血栓（ART）在高达10%的病例中存在。ART的管理具有挑战性，治疗选择有限。
病例总结
一名植入LVAD的54岁女性出现急性胸痛，左冠状动脉瓣叶有血栓形成。她接受了主动脉根部和冠状动脉的经皮机械抽吸（PMA）治疗且成功。她的国际标准化比值目标提高了，且ART未复发。
讨论
LVAD患者的ART常因主动脉瓣开放受损而产生，促进血栓形成。本病例证明了PMA作为手术切除的安全有效替代方法的实用性。
要点
ART是LVAD的关键并发症，需要及时诊断和治疗。PMA可为特定患者的ART提供明确且安全的治疗选择。
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