Stainback R F, Angelini P, Krajcer Z
Department of Cardiology, Texas Heart Institute, Houston 77030, USA.
Tex Heart Inst J. 1998;25(2):130-5.
Prosthetic valve thrombosis is a well-known condition. Because surgical treatment of prosthetic valve thrombosis is associated with a high mortality rate, the use of thrombolysis as therapy for this condition has gained popularity in recent years. In this article, we discuss the cases of 3 patients who presented to our institution with left-sided prosthetic valve thrombosis between 1994 and 1997. All 3 patients presented with New York Heart Association functional class III or IV symptoms, and all were successfully treated with urokinase. The use of thrombolytic therapy for left-sided prosthetic valve thrombosis is associated with low mortality rates, and therefore is an attractive alternative to valve replacement or thrombectomy. However, the risk of embolic and hemorrhagic complications precludes the use of thrombolysis in patients with large thrombi and in those with New York Heart Association functional class I and II symptoms; for these patients, the risk associated with thrombolysis exceeds surgical mortality rates.
人工瓣膜血栓形成是一种众所周知的病症。由于人工瓣膜血栓形成的外科治疗与高死亡率相关，近年来，使用溶栓疗法治疗这种病症已变得流行起来。在本文中，我们讨论了1994年至1997年间在我们机构就诊的3例左侧人工瓣膜血栓形成患者的病例。所有3例患者均表现为纽约心脏协会功能分级III级或IV级症状，并且均成功接受了尿激酶治疗。使用溶栓疗法治疗左侧人工瓣膜血栓形成的死亡率较低，因此是瓣膜置换或血栓切除术的一种有吸引力的替代方法。然而，栓塞和出血并发症的风险使得对于有大血栓的患者以及纽约心脏协会功能分级I级和II级症状的患者不能使用溶栓疗法；对于这些患者，与溶栓相关的风险超过了手术死亡率。
