Soyer H, Laudinat J M, Lemaître C, Pommier J L, Delepine G, Poncet A, Baehrel B, Bajolet A
Service de chirurgie cardiothoracique, hôpital Robert-Debré, CHU de Reims.
Arch Mal Coeur Vaiss. 1993 Dec;86(12):1769-71.
The authors report the case of a 32 year old woman with no risk factors for thromboembolism apart from a raised Lipoprotein (a) level, in whom a mobile thrombus of the ascending aorta was diagnosed only by transoesophageal echocardiography after multiple episodes of systemic embolism. After surgical excision the thrombus recurred and death ensued on the 17th postoperative day after multiple visceral embolism despite adequate anticoagulant therapy. This is a rare condition, the outcome of which seems often to be fatal, due to early recurrence irrespective of the treatment (anticoagulant or platelet antiaggregant therapy). This case illustrates the value of systematic transoesophageal echocardiography for the investigation of cerebral or peripheral ischaemic episodes without carotid artery disease and raises the problem of the best way of treating this pathology.
作者报告了一名32岁女性的病例，除脂蛋白(a)水平升高外，该患者无血栓栓塞风险因素。在多次发生全身栓塞后，仅通过经食管超声心动图诊断出升主动脉有活动血栓。手术切除血栓后复发，尽管进行了充分的抗凝治疗，但在多次内脏栓塞后的术后第17天死亡。这是一种罕见的疾病，由于早期复发，无论采用何种治疗方法（抗凝或血小板抗聚集治疗），其结果往往是致命的。该病例说明了系统性经食管超声心动图在无颈动脉疾病的脑或外周缺血性发作调查中的价值，并提出了治疗这种疾病的最佳方法问题。
