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Related Experiment Videos

[Intraoperative acute aortic obstructive embolism]

K Bendyk1, A Weyland, D Zenker

  • 1Zentrum Anaesthesiologie, Rettungs- und Intensivmedizin, Georg-August-Universität-Göttingen.

Der Anaesthesist
|November 1, 1996
PubMed
Summary
This summary is machine-generated.

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A rare case of acute aortic obstruction occurred during heart surgery due to a dislodged cardiac thrombus. Prompt intervention with a Fogarty catheter successfully removed the embolus, restoring lower extremity perfusion.

Area of Science:

  • Cardiovascular Surgery
  • Anesthesiology
  • Vascular Surgery

Background:

  • Coronary artery bypass grafting (CABG) is a common cardiac procedure.
  • Complications during CABG can arise from various sources, including thromboembolic events.
  • Maintaining adequate lower extremity perfusion is critical post-aortic declamping.

Observation:

  • A 36-year-old patient undergoing CABG experienced a sudden drop in femoral artery pressure post-aortic declamping.
  • Clinical signs of hypotension were absent, but lower extremities became pale and pulseless.
  • Radial artery pressure remained normal, indicating a localized obstruction.

Findings:

  • A large (6 x 3 cm) embolus was found occluding the aortic bifurcation.
  • The embolus was successfully removed using a Fogarty catheter.

Related Experiment Videos

  • The presumed origin of the embolus was a mural thrombus from an left ventricular aneurysm, mobilized during surgery.

    • Implications:

    • Acute embolic obstruction of the aorta is a rare but serious complication during cardiac surgery.
    • Consideration of intracardiac thrombus as a source is crucial in cases of sudden lower extremity perfusion deficits.
    • Transesophageal echocardiography monitoring may be beneficial for identifying patients at risk for intracardiac thrombus formation.