Intracardiac mobile thrombus and D-dimer fragment of fibrin in patients with mitral stenosis.
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OBJECTIVE--To investigate the relation between intracardiac thrombus and blood coagulability in patients with mitral stenosis. DESIGN--Prospective study. Cross sectional echocardiography and plasma concentrations of the D-dimer fragment of fibrin were used concurrently to detect intracardiac thrombus in patients with mitral stenosis. SETTING--Department of Medicine, National Cardiovascular Centre, Osaka, Japan. PATIENTS--63 patients with mitral stenosis. None of them had been receiving any anticoagulants or antiplatelet agents. MAIN OUTCOME MEASURES--Plasma concentrations of D-dimer in patients with a mobile intracardiac thrombus, those in patients with a non-mobile intracardiac thrombus, and those in patients without an intracardiac thrombus. RESULTS--A mobile intracardiac thrombus was found in 10 patients and a non-mobile thrombus in eight. The remaining 45 patients had no intracardiac thrombi. Plasma concentrations of D-dimer in the 10 patients with a mobile thrombus were all greater than 300 ng/ml (mean 983.3, 95% confidence interval 498.9 to 1467.7 ng/ml) and they were significantly higher than those in the patients with a non-mobile thrombus (226.2, 33.6 to 418.8 ng/ml) and the patients without an intracardiac thrombus (147.2, 110.4 to 184 ng/ml). CONCLUSIONS--A high plasma concentration of D-dimer seemed to reflect a hypercoagulable intracardiac state and may be a helpful indicator of the possible presence of mobile intracardiac thrombus in patients with mitral stenosis.To design a device for direct vision intracardiac operation without cardiopulmonary bypass, and assess its applicability preliminarily.The device was designed according to the clinical needs of intracardiac operation and used in operations for repairing atrial septal defect in 5 ex vivo porcine heart models. The practical applicability of this device was thoroughly tested and the results of the operations were evaluated.Direct vision operation for repairing atrial septal defect was successfully performed using this device, which can be a well applicable in some intracardiac operations, but its clinical effects need further evaluation.
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Aim To explore the correlation between thrombosis and density change of gores.Methods Using physic methods in new blood samples,the natural thrombus is taken and used the blood boltsof differentages(gores,flowing out of our bodies in different intervals) is used to calculate the changes of density parameters in the gores.Results During the process of thrombosis,the density of thrombus was increasing obviously along with the gore forming time.That made it positive relationship that density of the clot complied with the prolonging thrombus ageing.It reflected that all the state changes during thrombosis had distinct changes of physical parameters.Conclusion The results showed that thrombus density has the characteristics of the changing with the gore aging.This may also provide reliable evidence that the changes of thrombus structures and densities may improve the effect of intravascular ultrasonic thrombosis ablation and may be beneficial of clinic use.
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Negative correlation
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Confusion
Cardiac Pacing
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Heart neoplasms
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Objective To establish a model of deep venous thrombosis(DVT)in rats for dynamic study of antithrombotics or thrombolysis on thrombosis.Methods SD rats(n=60)were randomly divided into thrombosis model group(n=36),control group(n=18)and sham operation group(n=6).An improved method was used to make the inferior caval vein ligated in SD rats of thrombosis model group.After operation,rats in thrombosis model group and control group were divided into 6 period groups.The changes of thrombus and internal surface of vessels in each period were observed in thrombosis model group and were compared with those in other two groups,respectively.Results Stable venous thrombus were observed in all inferior caval vein in thrombosis model group,and the proximal part of venous thrombus was unobstructed and consistent with the pathological change of venous thrombosis during acute stage in human body.Conclusion The DVT model in rats was successfully established,which maybe helpful for dynamic study of the effect of antithrombotics or thrombolysis on thrombosis.
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275 cases of venous thrombosis were compared, and a conspicuous difference between clinical and phlebographic findings was discovered. The size alone of the thrombus has no relation to the symptoms it produces. 7 factors are presented to explain this lack of correlation: 1) Thrombosis in the rigid crural fascia causes more marked clinical symptoms than in other locations. 2) The larger the venous area to which the thrombus attaches itself, the more serious the symptoms. 3) In cases of deep venous thrombosis, if the superficial veins have dilated to aid collateral flow, venous congestion, an early indication of thrombosis, will be absent. 4) Ambulant patients have more pronounced symptoms than bed patients. 5) The faster a thrombus grows, the more marked are the symptoms of thrombosis. 6) Thrombosis can often be 1st diagnosed when the thrombus blocks the blood flow between the deep and the superficial veins. 7) Severe symptoms can arise if an earlier a symptomatic thrombus suddenly blocks the femoral canal.
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Abstract: Intracardiac thrombi can occur in a variety of locations and are frequently encountered in clinical practice. Yet evidence-based guidance for clinicians managing patients with intracardiac thrombi is often limited. This review summarizes what is known regarding the prevalence of intracardiac thrombus, diagnostic strategies, clinical relevance, and treatment options, focusing on four specific types of thrombus for which recent research has shifted clinical understanding and treatment decisions: (1) left atrial appendage thrombus, (2) cardiac implantable electronic device lead thrombus, (3) bioprosthetic aortic valve thrombus, and (4) left ventricular thrombus. Additional studies, ideally prospective, randomized, and head-to-head in design, are needed to better inform best practices in patients with intracardiac thrombi.
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