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机械二尖瓣置换术后血栓形成:一例报告

Mechanical Mitral Valve Prosthesis Thrombosis: A Case Report.

作者信息

Pareikaitė Viktorija, Makrickaitė Silvija, Bakšytė Giedrė

机构信息

Faculty of Medicine, Medical Academy, Lithuanian University of Health Sciences.

Department of Cardiology, Lithuanian University of Health Sciences, Kaunas Clinics.

出版信息

Acta Med Litu. 2025;32(1):132-137. doi: 10.15388/Amed.2025.32.1.13. Epub 2025 Feb 18.

Abstract

BACKGROUND

A rare but serious complication of heart valve replacement, prosthetic valve thrombosis carries significant risks of morbidity and mortality. Effective management depends on prompt diagnosis and the appropriate treatment, often involving fibrinolytic agents. Protocols using slower infusion rates and lower doses of these agents have led to improved therapy outcomes.

CLINICAL CASE

We report a case of a 56-year-old man admitted to the Lithuanian University of Health Sciences Kaunas Clinics due to mechanical mitral valve prosthesis thrombosis complicated by a respiratory failure and atrial fibrillation. The patient was treated with ultraslow thrombolysis with alteplase. The function of the mechanical valve prosthesis became normal, and the patient was discharged from the hospital.

DISCUSSION AND CONCLUSIONS

Managing prosthetic valve thrombosis is challenging due to overlapping clinical features with other diagnoses and the lack of consensus on the treatment methods. Slow-infusion, low-dose thrombolytic therapy with alteplase can be a life-saving intervention with a high success rate.

摘要

背景

人工心脏瓣膜血栓形成是心脏瓣膜置换术后一种罕见但严重的并发症,具有显著的发病和死亡风险。有效的治疗取决于及时诊断和恰当治疗,通常涉及使用纤溶药物。采用较慢输注速率和较低剂量这些药物的方案已改善了治疗效果。

临床病例

我们报告一例56岁男性患者,因机械性二尖瓣人工瓣膜血栓形成并发呼吸衰竭和心房颤动入住立陶宛健康科学大学考纳斯临床医院。该患者接受了阿替普酶超慢速溶栓治疗。机械性人工瓣膜功能恢复正常,患者出院。

讨论与结论

由于与其他诊断存在重叠的临床特征且治疗方法缺乏共识,人工瓣膜血栓形成的管理具有挑战性。阿替普酶慢输注、低剂量溶栓治疗可能是一种成功率高的挽救生命的干预措施。

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