Kanbak M, Ocal T
Department of Anesthesiology and Reanimation, Hacettepe University, Faculty of Medicine, Ankara, Turkey.
Can J Anaesth. 2000 May;47(5):460-2. doi: 10.1007/BF03018977.
To report a case of misplacement of a pulmonary artery catheter (PAC) into the carotid artery after open heart surgery.
A 20-mo-old boy underwent open heart surgery (VSD repair). On the first day postoperatively, he had severe pulmonary hypertension and a PAC was inserted via the left internal jugular approach without complication. Two hours later, chest radiography showed the PAC in the right internal carotid artery which it had reached via the right and left ventricles and aorta. The PAC was withdrawn and a new PAC was inserted and its position was confirmed by chest radiography. Two years later echocardiography failed to demonstrate the second VSD or a residual leak through the patch although a PAC could be passed from the right ventricle to the left ventricle and subsequently into the aorta and right carotid artery.
Correct placement of a PAC should be confirmed by chest radiography or other techniques to prevent complication.
报告1例心脏直视手术后肺动脉导管（PAC）误置入颈动脉的病例。
一名20个月大的男孩接受了心脏直视手术（室间隔缺损修补术）。术后第一天，他出现严重肺动脉高压，经左颈内静脉途径插入PAC，未出现并发症。两小时后，胸部X线片显示PAC位于右颈内动脉，它是经左右心室和主动脉到达此处的。将PAC拔出，重新插入一根新的PAC，并通过胸部X线片确认其位置。两年后，尽管PAC可从右心室进入左心室，随后进入主动脉和右颈动脉，但超声心动图未显示第二个室间隔缺损或补片处有残余分流。
应通过胸部X线片或其他技术确认PAC的正确放置，以预防并发症。
