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- Ludovic Chartier
- From the Service de Soins Intensifs Médicaux et de Réanimation Cardiaque (L.C., J.B., M.D., P.A., J.-J.B., C.T.), Service de Radiologie Vasculaire (J.-P.B.), and Service de Chirurgie Cardiaque B (H.W.), Hôpital Cardiologique, Lille, France.
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- Jérôme Béra
- From the Service de Soins Intensifs Médicaux et de Réanimation Cardiaque (L.C., J.B., M.D., P.A., J.-J.B., C.T.), Service de Radiologie Vasculaire (J.-P.B.), and Service de Chirurgie Cardiaque B (H.W.), Hôpital Cardiologique, Lille, France.
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- Maxence Delomez
- From the Service de Soins Intensifs Médicaux et de Réanimation Cardiaque (L.C., J.B., M.D., P.A., J.-J.B., C.T.), Service de Radiologie Vasculaire (J.-P.B.), and Service de Chirurgie Cardiaque B (H.W.), Hôpital Cardiologique, Lille, France.
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- Philippe Asseman
- From the Service de Soins Intensifs Médicaux et de Réanimation Cardiaque (L.C., J.B., M.D., P.A., J.-J.B., C.T.), Service de Radiologie Vasculaire (J.-P.B.), and Service de Chirurgie Cardiaque B (H.W.), Hôpital Cardiologique, Lille, France.
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- Jean-Paul Beregi
- From the Service de Soins Intensifs Médicaux et de Réanimation Cardiaque (L.C., J.B., M.D., P.A., J.-J.B., C.T.), Service de Radiologie Vasculaire (J.-P.B.), and Service de Chirurgie Cardiaque B (H.W.), Hôpital Cardiologique, Lille, France.
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- Jean-Jacques Bauchart
- From the Service de Soins Intensifs Médicaux et de Réanimation Cardiaque (L.C., J.B., M.D., P.A., J.-J.B., C.T.), Service de Radiologie Vasculaire (J.-P.B.), and Service de Chirurgie Cardiaque B (H.W.), Hôpital Cardiologique, Lille, France.
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- Henri Warembourg
- From the Service de Soins Intensifs Médicaux et de Réanimation Cardiaque (L.C., J.B., M.D., P.A., J.-J.B., C.T.), Service de Radiologie Vasculaire (J.-P.B.), and Service de Chirurgie Cardiaque B (H.W.), Hôpital Cardiologique, Lille, France.
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- Claude Théry
- From the Service de Soins Intensifs Médicaux et de Réanimation Cardiaque (L.C., J.B., M.D., P.A., J.-J.B., C.T.), Service de Radiologie Vasculaire (J.-P.B.), and Service de Chirurgie Cardiaque B (H.W.), Hôpital Cardiologique, Lille, France.
書誌事項
- タイトル別名
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- Diagnosis, Management, and Prognostic Indexes in 38 Consecutive Patients
抄録
<jats:p> <jats:italic>Background</jats:italic> —Floating right heart thrombi (FRHTS) are a rare phenomenon, encountered almost exclusively in patients with suspected or proven pulmonary embolism and diagnosed by transthoracic echocardiography. Their management remains controversial. </jats:p> <jats:p> <jats:italic>Methods and Results</jats:italic> —We report on a series of 38 consecutive patients encountered over the past 12 years. Thirty-two patients were in NYHA class IV, 20 in cardiogenic shock. Echocardiography usually demonstrated signs of cor pulmonale: right ventricular overload (91.7% of the population), paradoxical interventricular septal motion (75%), and pulmonary hypertension (86.1%). The thrombus was typically wormlike (36 of 38 patients). It extended from the left atrium through a patent foramen ovale in 4 patients. Pulmonary embolism was confirmed in all but 1. Mortality was high (17 of 38 patients) irrespective of the therapeutic option chosen: surgery (8 of 17), thrombolytics (2 of 9), heparin (5 of 8), or interventional percutaneous techniques (2 of 4). The in-hospital mortality rate was significantly linked with the occurrence of cardiac arrest. Conversely, the outcome after discharge was usually good, because 18 of 21 patients were still alive 47.2 months later (range, 1 to 70 months). </jats:p> <jats:p> <jats:italic>Conclusions</jats:italic> —Severe pulmonary embolism was the rule in our series of FRHTS (mortality rate, 44.7%). The choice of therapy had no effect on mortality. Emergency surgery is usually advocated. However, thrombolysis is a faster, readily available treatment and seems promising either as the only treatment or as a bridge to surgery. In patients with contraindications to surgery or lytic therapy, interventional techniques may be proposed. </jats:p>
収録刊行物
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- Circulation
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Circulation 99 (21), 2779-2783, 1999-06
Ovid Technologies (Wolters Kluwer Health)
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詳細情報 詳細情報について
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- CRID
- 1361981470015979264
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- ISSN
- 15244539
- 00097322
- http://id.crossref.org/issn/00097322
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- データソース種別
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- Crossref