出血性脳梗塞急性期に低用量heparinとnafamostat mesilateを併用した心臓手術

Cardiac Surgery Using Low-dose Heparin Combined with Nafamostat Mesilate in an Acute Hemorrhagic Stroke

急性期の出血性脳梗塞を伴う僧帽弁閉鎖不全症，左室内血栓症に対して低用量heparinにnafamostat mesilateを併用して手術を行ったので報告する．

A 66-year-old man presented to our hospital complaining palpitation and fatigue. He was diagnosed with heart failure secondary to mitral regurgitation, left ventricular thrombus, and hemorrhagic stroke in right cerebral hemisphere. Cardiac surgery under cardiopulmonary bypass during acute phase of stroke or cerebral hemorrhage carries significant risk, including exacerbation of neurological complications due to intraoperative anticoagulation. To mitigate this risk, we employed a low-dose heparin regimen combined with nafamostat mesilate continuous infusion during surgery. The patient successfully underwent mitral valve plasty and left ventricular thrombectomy, with a favorable postoperative course and no new neurological deficits.