기계 판막 혈전증 치험 3례 보고

Mechanical Valve Thrombosis -3 Cases-

  • 발행 : 1996.03.01

초록

유로키나제와 헤파린을 사용하여 혈전용해요법에 의해 치료된 기계판막 혈전의 3례를 경험하였다. 두 명의 환자는 완전히 회복하여서 자신의 직업과 활동적인 삶으로 되돌아갔으나, 다른 한 명은 뇌출혈과 뇌경색으로 사망하였다.

Despite anticoagulation, systemic embolization and anticoagulant-related hemorrhage are the major drawbacks of heart valve replacement with mechanical prostheses. Among many predisposing factors, inadequacy of anticoagulation is the most important one. Surgery can be reserved for patients who do not response to thrombolytic therapy, We have experienced 3 cases of prosthetic valve thrombosis treated by thrombolytic therapy by use of urokinase and heparin. Two patients fully recovered and returned to their employments and active lives but 1 patient,died of intracerebral hemorrhage and infarction. We report prosthetic valve thrombosis thrombolytic therapy with urokinase and heparin which was detected and serially followed by 2-dimensional echocardiography, cinefluoro copy, and monitoring of Swan-Ganz catherterized pressures.

키워드

참고문헌

  1. Ann Thorac Surg v.58 Thrombolysis in Left-Sided Prosthetic Valve Occlusion: Immediate and Follow-up Results Reddy,N.K.;Padmanabhan,T.N.C.;Singh,S.(et al.)
  2. 순환기 v.21 인공승모판막 혈전의 진단과 혈전용해요법 정남식;윤정한;장양수(등)
  3. Ann Thorac Surg v.57 Prosthetic valve Obstruction: Thrombolysis Versus Operation Vitale,N.;Renzulli,A.;Cerasuolo,F.(et al.)
  4. J An Coll Cardiol v.17 Obstruction of Mechanical Heart Valve Prostheses: Clinical Aspects And Surgical Management Deviri,E.;Sareli,P.;Wisenbaugh,T.;Cronje,S.L.(et al.)
  5. Circulation v.87 The St. Jude Valve Thrombolysis as the First Line of Therapy for Cardiac Valve Thrombosis Silber,H.;Khan,S.S.;Matloff,J.M.;Chaux,A.;DeRobertis,M.;Gray,R.
  6. Circulation v.84 no.SUP.Ⅲ Mechanical Cardiac Valve Thrombosis Is Thrombectomy Justified? Martinell,J.;Jimenez,A.;Rabago,G.;Artiz,V.;Fraile,J.;Farre,J.
  7. Circulation v.86 no.SUP.Ⅱ Mechanical Cardiac Valve Thrombosis Is Fibrinolysis Justified? Roudaut,R.;Labbe,T.;Lorient-Roudaut,M.F.(et al.)