経食道心エコーガイド下に左室内血栓除去術を施行した左心補助装置装着症例 Successful Treatment of Left Ventricular Thrombus Guided by Transesophageal Echocardiography in an Acute Myocardial Infarction Patient Implanted with a Left Ventricular Assist Device

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Abstract

冠動脈バイパス術後に左室補助装置(LVAD)を装着した患者に生じた左室内血栓を経食道心エコー(TEE)にて診断し,TEEガイド下に除去することができた。患者は高度の左心不全のためLVADを装着し,左室内に留置したカテーテルよりヘパリンの持続投与を行っていたが,装着後4日目にTEEにて左室内に有茎性の血栓が確認された。ウロキナーゼ投与は効果がなかったため,6日目に外科的摘出を行った。手術は人工心肺を用いて,TEEガイド下に血栓を吸引除去した。TEEはLVAD装着中の患者の左室内血栓の診断と治療に有用である。

This paper reports the successful treatment of a left ventricular thrombus detected and treated using transesophageal echocardiography (TEE) in an acute myocardial patient implanted with a left ventricular assist device (LVAD).<br>The patient underwent LVAD implantion because of severe left heart failure after coronary artery bypass grafting and anticoagulant therapy was performed by heparin administration via an indwelling catheter in the left ventricle space. On 4th day after implantation, a mobile, pedunculated, protruding left ventricular thrombus was detected by TEE, and subsequent thrombolytic therapy with urokinase infusion failed. Thus, on the 6th day surgical removal was attempted. During surgery, the thrombus was removed using a wall-sucker under TEE guidance.<br>We conclude that TEE is useful not only in the diagnosis of left ventricular thrombus, but also in its treatment.

Journal

  • Journal of the Japanese Society of Intensive Care Medicine

    Journal of the Japanese Society of Intensive Care Medicine 2(2), 57-60, 1995

    The Japanese Society of Intensive Care Medicine

Codes

  • NII Article ID (NAID)
    130003641517
  • Text Lang
    UNK
  • ISSN
    1340-7988
  • Data Source
    J-STAGE 
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