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

Abstract

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.

Keywords

• 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

Abstract

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.

Keywords

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

References

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