Valdivia J, Ferrá M, Moyano P, Garrido P
Servicio de Anestesiología, Reanimación y Terapia del dolor, Hospital Universitario Son Dureta, Palma de Mallorca.
Rev Esp Anestesiol Reanim. 2006 May;53(5):315-8.
A 29-year-old woman with a tubular thoracic aortic graft prosthesis, placed after repair of a postcoarctation site aneurysm, was reoperated due to fungal infection of the prosthesis. A left thoracotomy was performed and single lung ventilation established through a double lumen tube followed by extracorporeal circulation (ECC), deep hypothermia, and cessation of blood circulation. The venous drainage tube was placed in the right pulmonary artery and arterial return was located in the descending aorta. After replacement of the prosthesis and interruption of ECC, attempts to ventilate the right lung failed. Fiberoptic examination revealed that the carina and tracheal wall completely occluded the opening of the right main bronchus. ECC was interrupted and the left lung was ventilated, but after withdrawal of the tube from the pulmonary artery and repositioning the patient in supine decubitus, oxygenation and right lung ventilation improved. The patient was extubated after 20 hours and discharged home 6 weeks later.
一名29岁女性，在修复缩窄后部位动脉瘤后植入了管状胸主动脉移植假体，因假体真菌感染而再次手术。行左胸切开术，通过双腔管建立单肺通气，随后进行体外循环（ECC）、深度低温和血液循环停止。静脉引流管置于右肺动脉，动脉回血位于降主动脉。更换假体并中断ECC后，尝试对右肺进行通气失败。纤维光学检查显示，隆突和气管壁完全阻塞了右主支气管开口。中断ECC并对左肺进行通气，但在将导管从肺动脉拔出并将患者重新置于仰卧位后，氧合和右肺通气得到改善。患者在20小时后拔管，6周后出院回家。
