Cardiac arrest due to acute massive aortic root thrombosis after pericardial bioprosthetic aortic valve replacement
Cardiac arrest due to acute massive aortic root thrombosis after pericardial bioprosthetic aortic valve replacement
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DOI：
10.1016/j.carpath.2019.03.003
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发表时间：
2019-07-01
影响因子：
3.7
通讯作者：
Bottio, Tomaso
中科院分区：
文献类型：
--
作者：
Pradegan, Nicola;Basso, Cristina;Bottio, Tomaso
急性主动脉根部血栓延伸至冠状动脉口是一种罕见但可能危及生命的并发症主动脉瓣置换术与生物假体替代品。我们的目的是报告一名72岁的有症状的风湿性瓣膜疾病和相关心房颤动的女性患者，她接受了常规的双支架生物假体（分别为心包和猪）的小主动脉瓣置换术。术后8天，患者因心室颤动出现心脏骤停，需要立即心肺复苏。超声心动图显示左心室运动障碍，肌钙蛋白水平高达35000 ng/L提示冠状动脉缺血。急诊冠状动脉造影显示左主干亚闭合，怀疑主动脉根部血栓形成。患者立即再次手术，从主动脉根部取出新鲜血栓，并将主动脉Magna Ease 21毫米生物假体替换为无支架Solo Smart 21毫米生物假体。病人死于脓毒性并发症。(C) 2019 Elsevier Inc.版权所有。
Acute aortic root thrombosis extended to coronary ostia is a rare but potentially life-threatening complication of aortic valve replacement with bioprosthetic substitutes. We aimed to present the case of a 72-year-old woman with symptomatic rheumatic valve disease and associated atrial fibrillation who underwent conventional mitroaortic valve replacement with two stented bioprostheses (pericardial and porcine, respectively). Eight days after surgery, she had cardiac arrest due to ventricular fibrillation, requiring immediate cardiopulmonary resuscitation. Left ventricle akinesia by echocardiography and troponin levels up to 35,000 ng/L pointed to coronary ischemia. Emergent coronary angiography showed a subocclusion of the left main trunk, with the suspicion of aortic root thrombosis. The patient was immediately reoperated, fresh thrombi were removed from the aortic root, and the aortic Magna Ease 21-mm bioprosthesis was replaced with a stentless Solo Smart 21-mm bioprosthesis. The patient died of septic complications. (C) 2019 Elsevier Inc. All rights reserved.