Chevalier P, Bonnefoy E, Kirkorian G, Richalet C, Bourret N, Bouchayer D, Touboul P
Hôpital cardiovasculaire et pneumotegique, Lyon.
Arch Mal Coeur Vaiss. 1996 Sep;89(9):1209-11.
The authors report the case of a 63-year-old woman with occlusive thrombosis of a mitral valve prosthesis and cardiogenic shock successfully treated by systemic thrombolytic therapy. This treatment was given despite metastatic hepatic and bone breast cancer. This, and other recently reported cases, argues in favour of widening the indication of thrombolysis as treatment of first intention in cases of obstruction of atrioventricular valve prostheses. Nevertheless, the relative safety of surgical treatment and the risk of systemic thromboembolism of thrombolysis, incites caution and reservation of medical therapy for carefully selected patients.
作者报告了一例63岁女性患者，其二尖瓣人工瓣膜发生闭塞性血栓形成并伴有心源性休克，经全身溶栓治疗成功治愈。尽管该患者患有转移性肝和骨乳腺癌，但仍进行了这种治疗。这一病例以及其他近期报道的病例表明，对于房室瓣人工瓣膜梗阻病例，应扩大溶栓作为首选治疗方法的适应症。然而，手术治疗的相对安全性以及溶栓导致全身血栓栓塞的风险，促使人们在为精心挑选的患者保留药物治疗时要谨慎行事。
