Fatal cerebral thrombosis after pericardiectomy.

IF 2 Q2 EMERGENCY MEDICINE
Qin Jiang, Tao Yu, Keli Huang, Bing Huang, Xiang Huang, Shengshou Hu
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引用次数: 0

Abstract

Background: Pericardiectomy due to constrictive pericarditis is usually safe procedure. There was a rare event of thrombosis after pericardiectomy, which was mainly accounted by low-cardiac-output syndrome.

Case presentation: Here, we report the case undergoing pericardiectomy after constrictive pericarditis, with fatal cerebral thrombosis after pericardiectomy confirmed by endovascular mechanical thrombectomy. Even though recanalization was completed and suggestive decompressive craniectomy was in preparation, the patient still died for cerebral hernia due to severe edema. The causes of cerebral thrombosis after pericardiectomy in this case was accounted by the persistence of nonpliable pericardium encasing the left ventricular wall limited local myocardium motor, pro-coagulable state due to thermal transmission during decortication like radiofrequency ablation under the condition of postoperative atrial fibrillation and rapid ventricular rates precipitated the information of mural thrombus in cardiac cavity and migration into the main branch of the aortic arch.

Conclusion: The protocol of prompt aggressive anticoagulation prophylaxis would be vigilantly recommended for the patients undergoing pericardiectomy.

心包切除术后致命的脑血栓。
背景:因缩窄性心包炎而进行的心包切除术通常是安全的手术。心包切除术后出现血栓形成的情况非常罕见,主要原因是低心输出量综合征:在此,我们报告了一例在缩窄性心包炎后接受心包切除术的病例,该病例在心包切除术后出现致命性脑血栓,经血管内机械取栓术证实。尽管已经完成了再通路,并准备进行暗示性减压开颅手术,但患者仍因严重水肿导致脑疝而死亡。该病例心包切除术后脑血栓形成的原因是:包裹左心室壁的不柔软心包持续存在,限制了局部心肌的运动;术后心房颤动和心室率过快的情况下,解痉过程中的热传递(如射频消融)导致促凝状态,从而在心腔内形成壁血栓并迁移至主动脉弓主支:结论:建议对接受心包切除术的患者进行及时、积极的抗凝预防治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.60
自引率
0.00%
发文量
63
审稿时长
13 weeks
期刊介绍: The aim of the journal is to bring to light the various clinical advancements and research developments attained over the world and thus help the specialty forge ahead. It is directed towards physicians and medical personnel undergoing training or working within the field of Emergency Medicine. Medical students who are interested in pursuing a career in Emergency Medicine will also benefit from the journal. This is particularly useful for trainees in countries where the specialty is still in its infancy. Disciplines covered will include interesting clinical cases, the latest evidence-based practice and research developments in Emergency medicine including emergency pediatrics.
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