Oral antikoagülasyon ile tedavi edilen serbest yüzen sol atriyal top trombüsü

Abstract

Dış merkeze karın ağrısı nedeniyle başvurup böbrek ve dalakta enfarktüs saptanması nedeniyle ileri inceleme için hastanemize yönlendirilen, mekanik protez mitral kapak nedeniyle varfarin almakta olan ancak yakın zamanda kalp dışı cerrahi nedeniyle varfarin kesilip enoksaparin ile tedavi öyküsü olan 56 yaşındaki bir erkek hastaya tarafımızca yapılan transözofageal ekokardiyografide (TEE) serbest yüzen sol atriyal top trombüsü saptandı. Kalp cerrahları tarafından cerrahi müdahale açısından yüksek riskli olarak değerlendirilen hasta, varfarin rejimi ile tedavi edildi ve tedavinin 14. gününde bilgisayarlı tomografi (BT) taramasında trombüsün kaybolduğu görüldü. Bu olgu sunumuna göre, serbest yüzen sol atriyal top trombüsü olan hastalar cerrahi girişim açısından yüksek risk altındaysa, cerrahiye alternatif olarak varfarin tedavisi düşünülebilir.

Keywords

• Trombüs
• Antikoagülasyon
• Ekokardiyografi

A free floating left atrial ball thrombus treatment with oral anticoagulation

Abstract

Transesophageal echocardiography (TEE) revealed a free-floating left atrial ball thrombus in a 56-year-old male patient who was taking warfarin for mechanical prosthetic mitral valve and had recently short-term warfarin interruption for noncardiac surgery and bridging with enoxaparin was admitted to an external center for left abdominal pain and after the detection of spleen and renal infarct, the patient was referred to us for further examination. The patient, who was considered to be at high risk for surgical intervention by the cardiac surgeons, was treated with a warfarin regimen and on the 14th day of the treatment, computed tomography (CT) scan showed that the thrombus disappeared. According to this case report, if patients who have a free-floating left atrial ball thrombus are at high risk for surgical intervention, warfarin therapy can be considered as an alternative to surgery

Keywords

• Thrombus
• Anticoagulation
• Echocardiography

References

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