[A case of cardiogenic embolism, which occurred under appropriate warfarin use, treated with thoracoscopic left atrial appendectomy].
Rinsho Shinkeigaku
; 58(1): 9-14, 2018 Jan 26.
Article
em Ja
| MEDLINE
| ID: mdl-29269690
ABSTRACT
A 74-year-old man with a past medical history of bradycardiac atrial fibrillation and an old cerebral infarction presented with dysarthria. He had been treated with warfarin and PT-INR on admission was 2.0. MRI of the head revealed an acute ischemic stroke involving the cerebellum and left occipital lobe. Because transesophageal cardiac echography showed a thrombus in the left atrial appendage, anticoagulant treatment with warfarin and heparin was initiated. The thrombus was enlarging; therefore, we changed the anticoagulant therapy to apixaban with heparin on day 11. On day 17, a hemorrhagic cerebral infarction occurred. After the hemorrhage diminished, we treated him with warfarin aiming for a PT-INR between 3 and 4. The thrombus gradually shrank and disappeared on day 110. Finally, a thoracoscopic left atrial appendectomy was performed as a secondary prevention, with no recurrence till date.
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Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Toracoscopia
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Trombose
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Varfarina
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Infarto Cerebral
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Átrios do Coração
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Cardiopatias
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Procedimentos Cirúrgicos Cardíacos
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Anticoagulantes
Limite:
Aged
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Humans
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Male
Idioma:
Ja
Revista:
Rinsho Shinkeigaku
Ano de publicação:
2018
Tipo de documento:
Article