Τίτλος:
How should i treat a TAVI-eligible patient with a left ventricular thrombus and rapid clinical deterioration?
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
BACKGROUND: An 89-year-old male with heart failure due to severe aortic stenosis and chronic renal failure was scheduled for transcatheter aortic valve implantation (TAVI). INVESTIGATION: The day before the procedure the patient underwent an echocardiogram (as per in-house pre-procedural protocol). A large mobile thrombus was discovered at the left ventricular apex, and the TAVI procedure was cancelled. DIAGNOSIS: Severe calcific aortic stenosis with a large mobile intracavitary thrombus. MANAGEMENT: As the patient presented four weeks later with worsening symptoms of acute heart failure and could not be weaned from intravenous furosemide, the Heart Team decided to proceed with TAVI, trying to minimise wire manipulations throughout the procedure. An Evolut R system was implanted with no complications. Three days after the procedure, the patient was off intravenous diuretics and able to walk around the ward. © Europa Digital & Publishing 2017. All rights reserved.
Συγγραφείς:
Deftereos, S.
Giannopoulos, G.
Raisakis, K.
Vrettou, A.-R.
Kolokathis, F.
Zacharoulis, A.
Angouras, D.
Alexopoulos, D.
Lekakis, J.
Περιοδικό:
EuroIntervention
Λέξεις-κλειδιά:
acenocoumarol; enoxaparin; furosemide, acute heart failure; aged; aortic stenosis; aortic valve calcification; Article; case report; chronic kidney failure; clinical article; deterioration; disease severity; heart left ventricle; heart left ventricle ejection fraction; heart ventricle thrombosis; human; left ventricular apex; male; transcatheter aortic valve implantation; transthoracic echocardiography; tricuspid valve regurgitation; very elderly; aortic valve stenosis; deterioration; diagnostic imaging; procedures; thrombosis; transcatheter aortic valve implantation; treatment outcome, Aged, 80 and over; Aortic Valve Stenosis; Clinical Deterioration; Humans; Male; Thrombosis; Transcatheter Aortic Valve Replacement; Treatment Outcome
DOI:
10.4244/EIJ-D-16-00338
