심한 좌심방 석회화와 반복적인 좌심방 혈전 및 액와부 혈종
Severe Calcification of the Left Atrial Wall with Left Atrial Thrombi and an Axillary Hematoma
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초록
저자들은 23년 전에 류마티스성 승모판 협착증, 좌심방 혈전이 동반되어 기계 판막을 이용한 승모판 치환술 및 좌심방 혈전 제거술을 시행한 뒤에 진행하는 좌심방의 심한 심내막 석회화와 좌심방 혈전 및 액와부의 혈종이 발생한 1예를 경험하였다.
Abstract
Left atrial wall calcification is frequently observed in patients with rheumatic valvular heart disease. However, massive left atrial wall calcification, so called porcelain or coconut atrium, with left atrium thrombi is very rare. Here, we describe the case of a 67-year-old male patient with porcelain atrium, recurrent left atrial thrombi, and a spontaneous axillary hematoma after mitral valve replacement and surgical thrombectomy due to rheumatic valvular heart disease. The patient underwent two valvular surgeries 20 years prior; therefore, we determined not to perform additional surgeries because of a high risk of morbidity, mortality, and the recurrence of atrial thrombi. The patient has been maintained on daily warfarin as an anti-thrombic therapy for more than 5 years without major embolic complications. (Korean J Med 2012;82:729-733)
참고문헌 (15)
- Bloch HM, "Calcification of the left atrium", S Afr Med J, 52, pp.184~186 (1997)
- Van de Sande R, "Left atrial calcification: a case studied by angiocardiography", Acta Cardiol, 23, pp.471~480 (1968)
- Del Campo C, "Coconut atrium: transmural calcification of the entire left atrium", Tex Heart Inst J, 27, pp.49~51 (2000)
- Ha JW, "Porcelain atrium", Clin Cardiol, 24, pp.484~ (2001)
- Minatoya K, "Calcified ball thrombus in the left atrium", Ann Thorac Surg, 61, pp.1513~1514 (1996)
- Kasliwal RR, "A study of spontaneous echo contrast in patients with rheumatic mitral stenosis and normal sinus rhythm: an Indian perspective", Br Heart J, 74, pp.296~299 (1995)
- Daimee MA, "Left atrial appendage function in mitral stenosis: is a group in sinus rhythm at risk of thromboembolism?", Int J Cardiol, 66, pp.45~54 (1998)
- Ozkan M, "Predictors of left atrial thrombus and spontaneous echo contrast in rheumatic valve disease before and after mitral valve replacement", Am J Cardiol, 82, pp.1066~1070 (1998)
- Chiang CW, "Predictors of systemic embolism in patients with mitral stenosis: a prospective study", Ann Intern Med, 128, pp.885~889 (1998)
- Tabata T, "Influence of left atrial pressure on left atrial appendage flow velocity patterns in patients in sinus rhythm", J Am Soc Echocardiogr, 9, pp.857~864 (1996)
- Pulikal G, "Images in clinical medicine: complete calcification of a rheumatic left atrium", N Engl J Med, 354, pp.2262~ (2006)
- Vallejo JL, "Massive calcification of the left atrium: surgical implications", Ann Thorac Surg, 60, pp.1226~1229 (1995)
- 소영호, "승모판 치환 후 좌심방 벽 석회화: 전산화 단층 촬영소견 및 임상적 의의", 대한영상의학회지, 47(6), pp.607~613 (2002), 대한영상의학회
- Harthorne JW, "Left atrial calcification: review of literature and proposed management", Circulation, 34, pp.198~210 (1966)
- 김성훈, "좌심방 석회화와 관련된 반복된 좌심방 혈전 1예", Korean Circulation Journal, 34(3), pp.323~327 (2004), 대한심장학회