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Nonoperative management of aortic valve thrombus in a patient with left ventricular assist device

机译：左心室辅助装置患者的主动脉瓣血栓的非手术治疗

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A 70-year-old Hispanic female presented with severely decompensated dilated cardiomyopathy on milrinone infusion at home. She was classified as New York Heart Association functional classes III-IV and received maximal medical management in the hospital. Cardiac catheterization redemonstrated increased pressures in right atrium, right ventricle, and pulmonary artery with a cardiac index of 1.25 L/ min/m2 and left ventricular ejection fraction of 10%. The patient was considered for heart transplant but could not wait for a donor heart because of high panel-reactive antibodies. A left ventricular assist device (HeartMate-II, Thoratec Corp., Pleasanton, CA, USA) was implanted. Systemic anticoagulation therapy was started on postoperative day (POD) 2 with warfarin. The patient was also maintained on aspirin (81 mg, daily) and dipyridamole (75 mg, three times a day) therapy, and the international normalized ratio (INR) was targeted at 2.0-2.5.
机译：一名70岁的西班牙裔女性因在家中服用米力农而出现严重失代偿性扩张型心肌病。她被归类为纽约心脏协会功能分类III-IV，并在医院接受了最大程度的医疗管理。心脏导管检查显示右心房，右心室和肺动脉压力增加，心脏指数为1.25 L / min / m2，左心室射血分数为10％。该患者被考虑进行心脏移植，但由于面板反应性强，无法等待供体心脏。植入了左心室辅助装置（HeartMate-II，Thoratec Corp.，美国加利福尼亚州普莱森顿）。术后第2天（POD）开始使用华法林进行全身抗凝治疗。患者还接受阿司匹林（每日81毫克）和双嘧达莫（75毫克，每天3次）治疗，国际标准化比率（INR）的目标为2.0-2.5。

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