- 期刊
Management of Mechanical Heart Valve Obstruction
機械性人工心臟瓣膜阻塞的處理
摘要
機械性心臟瓣膜阻塞是發生在機械性心臟瓣膜置換術病人的嚴重併發症之一，快速且正確的診斷及治療與病人的預後及死亡率有關。然而，機械性心臟瓣膜阻塞因多樣的臨床表徵及心臟瓣膜阻塞的程度，造成診斷的困難度和治療的延誤。經胸前或經食道心臟超音波及螢光鏡透視攝影檢查術是主要的診斷工具。機械性心臟瓣膜阻塞的治療則分爲手術－包括心臟瓣膜再置換術及血栓切除術，或內科治療－血栓溶解劑二種方式，雖然文獻中已有許多個案報告及大型隨機性的研究來探討此兩種治療，但並無明確證據兩者優劣。此篇文章目的是回溯文獻中對機械性心臟瓣膜阻塞相關的討論並提供治療上的建議。
關鍵字
無資料並列摘要
Mechanical valve obstruction is a serious complication of mechanical valve prosthesis. The significant morbidity and mortality associated with this condition warrants rapid diagnostic evaluation. However, diagnosis can be challenging, mainly because of variable clinical presentations and the degree of valvular obstruction. Echocardiography, either transthoracic or transesophageal, and cinefluoroscopy represent the main diagnostic procedures. Treatment with either surgical approach including valvular re-replacement or thrombectomy or medical approach using thrombolysis is two established therapies for prosthetic valve thrombosis. Results from many randomized clinical trials have showen that there is no evidence that either of the two treatment options offers superior results to the other. The purpose of this article is to review the relevant information of prosthetic valve obstruction and provide recommendations for management.