在右心房大规模切除期间的手术内肺栓塞:手术内救援TEE的病例报告
Manjusree Guha1, Arun Maheshwari, Sandeep Joshi
1Department of Cardiac Anesthesia, Sir Gangaram Hospital, New Delhi, India.
Annals of cardiac anaesthesia
|October 13, 2025
概括
在心脏手术期间的手术内肺栓塞是罕见的. 经食道心声学 (TEE) 引导成功管理患有右心房质量导致血动力学崩的患者.
科学领域:
- 心脏病学 心脏病学
- 手术并发症 手术并发症
- 医疗成像医学成像
背景情况:
- 内手术性肺栓塞是心脏手术期间罕见但严重的并发症,特别是在右心房质量.
- 一名62岁的女性患者患有并发症,出现呼吸困难,表明心脏问题.
研究的目的:
- 报告一个经历了右心房质量的二次性手术内肺栓塞的患者的成功管理.
- 突出跨食道心声学 (TEE) 在诊断和指导手术干预这种并发症的关键作用.
主要方法:
- 在手术前的心声回声检查中,发现了一种移动的右心房质量,通过三巴进行了前进.
- 在手术过程中使用过食道心声图 (TEE) 来确认因大体栓塞而导致的血液动力学崩.
- 修改了手术方法,包括在深度低温循环停止下进行肺血栓切除.
主要成果:
- 患者经历了麻醉诱导后突然的血液动力学崩,通过手术内TEE确认为肺栓塞.
- 经过修改的手术程序,包括肺血栓切除术,成功进行了.
- 在实时诊断和指导关键手术决策方面,TEE发挥了重要作用.
结论:
- 通过及时诊断和手术干预,可以从右心房质量中成功管理手术期间的肺栓塞.
- 过食管回声心脏图 (TEE) 是在这些复杂的心脏手术病例中进行手术内监测和决策的必不可少的工具.
关键词:
肺栓塞 肺栓塞 是一种肺栓塞.右心房神经瘤 (右心房神经瘤)进行血栓切除术 (thrombectomy).过食管回声心电图 (transesophageal echocardiography) 是一种通过食管回声心电图进行心脏回声的方法.更多相关视频
07:41Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
4.2K
07:02A Large Animal Model for Pulmonary Hypertension and Right Ventricular Failure: Left Pulmonary Artery Ligation and Progressive Main Pulmonary Artery Banding in Sheep
Published on: July 15, 2021
3.6K
相关概念视频
Cardiac Catheterization II: Right Heart Catheterization
Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
Pulmonary Embolism I: Introduction
Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
Pulmonary Embolism III: Nursing Management
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
Pulmonary Embolism I: Introduction
A blood clot, or thrombus, is a semi-solid mass composed of fibrin, platelets, and red blood cells. When it forms within a vessel, it can obstruct blood flow, known as thrombosis. If part of the clot detaches, it becomes an embolus that can travel and block distant vessels. When this occurs in the pulmonary arteries, it causes a condition known as pulmonary embolism (PE).Origin and ImpactMost often, the embolus originates from a thrombus in the deep veins of the lower limbs, a condition called...
