有效超低剂量溶栓治疗主动脉生物瓣血栓形成
Effective Ultraslow Low-Dose Thrombolysis for Aortic Bioprosthetic Valve Thrombosis.
作者信息
Páez-Zamora Laura Juliana, Durán Angélica Rojas
机构信息
Los Cobos Medical Center, Universidad El Bosque, Bogotá, Colombia.
Los Cobos Medical Center, Universidad El Bosque, Bogotá, Colombia.
出版信息
JACC Case Rep. 2025 Aug 20;30(24):104678. doi: 10.1016/j.jaccas.2025.104678.
BACKGROUND
Bioprosthetic valve thrombosis (BPVT) is rare, with an incidence of 0.2% to 6.0%. It often presents as heart failure, thromboembolism, or a new murmur. Diagnosis relies on transthoracic and transesophageal echocardiography, with treatment traditionally being surgical.
CASE SUMMARY
We report a 74-year-old patient with valvular and Chagas-related heart disease who developed BPVT of the aortic valve. Owing to high surgical risk and lack of response to heparin, ultraslow low-dose thrombolysis was performed, achieving a successful outcome.
DISCUSSION
The emerging therapies for BPVT have a lower risk of mortality when compared with surgical management. Although to our knowledge there are no studies regarding the use of ultraslow low-dose thrombolysis on patients with aortic BPVT, this case demonstrates the safety and efficacy of this approach.
背景
生物瓣血栓形成（BPVT）较为罕见，发病率为0.2%至6.0%。其常表现为心力衰竭、血栓栓塞或新出现的杂音。诊断依赖于经胸和经食管超声心动图，传统治疗方法为手术治疗。
病例摘要
我们报告一例74岁患有瓣膜性和恰加斯病相关心脏病的患者，其发生了主动脉瓣BPVT。由于手术风险高且对肝素无反应，遂进行了超慢速低剂量溶栓治疗，并取得了成功。
讨论
与手术治疗相比，BPVT的新兴治疗方法死亡率较低。尽管据我们所知，尚无关于对主动脉BPVT患者使用超慢速低剂量溶栓治疗的研究，但本病例证明了该方法的安全性和有效性。
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