Thrombus in the distal aortic arch after apicoaortic conduit for severe aortic stenosis.
Thrombus in the distal aortic arch after apicoaortic conduit for severe aortic stenosis.
复制标题
心尖主动脉导管后主动脉弓远端血栓，用于严重主动脉瓣狭窄。
DOI：
10.1510/icvts.2009.220707
复制
发表时间：
2010
影响因子：
--
通讯作者：
T. Shibata
中科院分区：
文献类型：
--
作者：
Shinsuke Kotani;K. Hattori;Y. Kato;T. Shibata
我们报告一例罕见的血栓形成在远端主动脉弓后的顶主动脉导管（AAC）严重主动脉狭窄（AS）。一名71岁妇女因升主动脉严重钙化，接受了严重AS的AAC和生物假体瓣膜。虽然进行了华法林抗凝治疗，但术后计算机断层扫描显示主动脉弓远端有血栓。磁共振成像（MRI）显示该部位血流停滞。继续使用华法林。术后6个月的后续ct扫描显示血栓明显减少。后续MRI显示，手术后一年，通过主动脉瓣的顺行血流减少。我们认为血栓形成可能发生在AAC后，因为血流停滞，血流分布可能在随访期间发生变化。因此，我们建议术后立即开始抗凝治疗，即使使用生物假体瓣膜。
We report an uncommon case of thrombogenesis in the distal aortic arch after apicoaortic conduit (AAC) for severe aortic stenosis (AS). A 71-year-old woman underwent AAC with a bioprosthetic valve for severe AS because of heavy calcification of the ascending aorta. Although anticoagulant therapy with warfarin was performed, a postoperative computed tomographic (CT) scan revealed a thrombus in the distal aortic arch. Cine magnetic resonance imaging (MRI) revealed stagnation of the blood flow at that site. Administration of warfarin was continued. A follow-up CT-scan showed a marked reduction of the thrombus at six months after the surgery. A follow-up MRI revealed that the antegrade flow through the native aortic valve was decreased at one year after the surgery. We suggest that thrombogenesis may occur after AAC because of stagnation of the blood flow and that the distribution of the blood flow may change during the follow-up period. Therefore, we recommend that postoperative anticoagulant therapy should be initiated immediately, even when a bioprosthetic valve is used.