tailieunhanh - báo cáo khoa học: " The first three-dimensional visualization of a thrombus in transit trapped between the leads of a permanent dual-chamber pacemaker: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: The first three-dimensional visualization of a thrombus in transit trapped between the leads of a permanent dual-chamber pacemaker: a case report | Maagh et al. Journal of Medical Case Reports 2010 4 359 http content 4 1 359 jAl JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access The first three-dimensional visualization of a thrombus in transit trapped between the leads of a permanent dual-chamber pacemaker a case report 1 1 2 1 1 1 Petra Maagh Thomas Butz Andreas Ziegler Axel Meissner Magnus W Prull Hans-J Trappe Abstract Introduction Two-dimensional echocardiography is a useful tool in diagnosing cardiac masses. However the three-dimensional offline reconstruction technique of transesophageal echocardiography might be superior to twodimensional transesophageal echocardiography in providing additional information of structural details. Case presentation We report the case of a 76-year-old Caucasian man with a permanent dual-chamber pacemaker and a worm-like right-heart thrombus in transit. Two-dimensional transthoracic echocardiography and two-dimensional transesophageal echocardiography showed that it was debatable as to whether the worm was originating from the leads. Offline three-dimensional transesophageal echocardiography reconstruction technique proved superior in identifying the cardiac mass as a thrombus trapped between the leads of the pacemaker. The thrombus was successfully dissolved by systemic heparin therapy. Conclusions The three-dimensional transesophageal echocardiography is useful and effective in patients with implanted pacemakers or defibrillators when other closely competing imaging modalities are contraindicated such as magnetic resonance imaging. In patients with pacemakers and trapped thrombus in transit for whom surgical therapy might be a high risk medical therapy seems to offer a safer and convincing alternative. Whether the management of right-heart thrombi has to be modified due to the presence of pacemaker leads is controversial. Introduction In the context of different imaging modalities twodimensional 2D transesophageal echocardiography TEE

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