Thrombolytic Therapy as the Management of Mitral Transcatheter Valve-in-Valve Implantation Early Thrombosis
Thrombolytic Therapy as the Management of Mitral Transcatheter Valve-in-Valve Implantation Early Thrombosis
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DOI：
10.1016/j.hlc.2015.12.003
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发表时间：
2016-05-01
影响因子：
2.6
通讯作者：
Dahdouh, Ziad
中科院分区：
文献类型：
--
作者：
Akhras, Nathem;Al Sergani, Hani;Dahdouh, Ziad
一名70岁男性因11年前植入的失败生物瓣膜接受二尖瓣经导管瓣中瓣植入术。在手术后的第一天，他的新生物瓣膜出现血栓形成，瓣尖运动受限。尽管使用普通肝素输注进行了有效的抗凝治疗，但二尖瓣平均跨瓣压差仍显著增加。低剂量和缓慢输注阿替普酶导致血栓消退和瓣尖运动正常化。此后，开始使用维生素K拮抗剂进行长期抗凝治疗，患者仍无症状。
A 70-year-old male underwent mitral transcatheter valve-in-valve implantation for a failed bioprosthesis implanted 11 years earlier. In the first days following the procedure, he developed thrombosis of the new bioprosthesis with restricted cusp motion. The transmitral mean gradient increased significantly despite effective anticoagulation therapy using unfractionated heparin infusion. Low dose and slow infusion of alteplase resulted in resolution of the thrombus and normalisation of cusp motion. Thereafter long-term anticoagulation using a vitamin K antagonist was instituted and the patient remained asymptomatic.