在非抽冠状动脉旁路移植期间,在左心室中意外检测到气泡:一个病例报告
Youna Sim1, Boohwi Hong2, Sang Jun Park1
1Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital, Daejeon, Republic of Korea.
Journal of cardiothoracic surgery
|December 20, 2024
概括
无冠状动脉旁路移植 (OPCAB) 很少导致气栓塞. 一个罕见的病例涉及到只在左心室检测到的气泡,强调了在CO2灌注期间需要保持警的需要.
科学领域:
- 心血管外科心血管外科
- 麻醉学 麻醉学
- 心脏病学 心脏病学
背景情况:
- 与式手术相比,非式冠状动脉旁路移植 (OPCAB) 通常与心内气栓塞风险较低.
- 在OPCAB期间报告了空气栓塞,特别是在使用二氧化碳 (CO2) 吹风器用于解位可视化时.
- 这份报告详细介绍了OPCAB期间在左心室中出现空气泡的不同寻常情况.
研究的目的:
- 报告一个罕见的左心室气泡在非抽动冠状动脉旁路移植期间的情况.
- 在OPCAB过程中识别空气进入左心室的潜在路径.
- 强调在OPCAB程序中监测气栓塞的重要性.
主要方法:
- 一名72岁的患有心肌梗塞的男性患者因扩散性冠状动脉狭窄而紧急接受了OPCAB.
- 二氧化碳 (CO2) 吸入用于在解剖术期间的可视化.
- 通过食道的心声回声 (TEE) 被用于监测;患者被放置在Trendelenburg以减轻气栓塞风险.
主要成果:
- 显著的气泡仅在左心室内被观察到.
- 在心脏右侧没有检测到气泡.
- 患者在住院期间没有经历神经复杂症.
结论:
- 空气通过一个特定的途径进入左心室,可能与CO2吹风机的使用有关.
- 应避免过度的二氧化碳流速在解时,以最大限度地降低气栓塞的风险.
- 使用TEE的持续监测对于在OPCAB期间检测气泡至关重要,即使在罕见的情况下也是如此.
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