Tıkayıcı Mekanik Aort Kapak Trombozu Olan Bir Hastanın Seri Floroskopi Kılavuzluğunda Pıhtı Eritici İlaç ile Tedavisi

Yıl 2016, Cilt: 19 Sayı: 3, 191 - 194, 01.12.2016

Macit Kalçık Mahmut Yesin Mustafa Ozan Gürsoy Mustafa Yıldız Mehmet Özkan

Öz

Protez kapak
trombozu genellikle yetersiz antikoagüle edilmiş hastalarda rastlanan hayatı
tehdit edici bir komplikasyondur. Protez kapak trombozu tanısında 2-boyutlu ve
gerçek zamanlı 3-boyutlu transözafajeal ekokardiyografi altın standart
görüntüleme yöntemleri olmasına rağmen, bu yöntemlerle aort konumundaki protez
kapaklar çok net değerlendirilemeyebilir. Bu durum protez aort kapak trombozu
nedeniyle trombolitik  tedavi alan
hastaların takibinde önemli bir problem oluşturur. Floroskopi bu şekilde kapak
hareketlerinde kısıtlılık olan hastaların takibinde kapak hareketleri hakkında
değerli bilgiler sunan alternatif noninvaziv görüntüleme yöntemidir. Burada bir
protez aort kapak trombozu tanılı olguda seri floroskopi kılavuzluğunda düşük
doz (25 mg) doku plazminojen aktivatörünün çok yavaş infüzyonu (25 saat) ile
yapılan trombolitik tedaviyi sunmaktayız.

Anahtar Kelimeler

Floroskopi, protez kapak trombozu, aort kapak, trombolitik tedavi, doku plazminojen aktivatörü

Serial Fluoroscopy Guided Fibrinolytic Therapy in a Patient with Obstructive Mechanical Aortic Valve Thrombosis

Öz

Prosthetic
valve thrombosis is a life-threatening complication, which is most commonly
seen in patients with poor anticoagulation. Although two-dimensional and
real-time three-dimensional transesophageal echocardiography are the gold
standard imaging modalities for the diagnosis of prosthetic valve thrombosis,
prosthetic valves in aortic position may not be evaluated precisely. This is a
serious problem during the follow-up of the patients who receive thrombolytic
therapy for aortic valve thrombosis. Fluoroscopy is an alternative noninvasive
imaging method, which provides valuable information about leaflet motion and
may be used for such cases with restricted leaflets. Here, we report a case of
aortic valve thrombosis that was managed with low-dose (25 mg) and ultra-slow
(25 hours) infusion of tissue-type plasminogen activator under the guidance of
serial fluoroscopy.

Anahtar Kelimeler

Fluoroscopy, prosthetic valve thrombosis, aortic valve, thrombolytic therapy, tissue-type plasminogen activator

Kaynakça

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