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病例报告:经房间隔导管插入术期间在电生理实验室发生的脑空气栓塞:急性左半身轻瘫的及时高压氧治疗的治愈性治疗。

Case report: Cerebral air embolization in the electrophysiology laboratory during transseptal catheterization: curative treatment of acute left hemiparesis with prompt hyperbaric oxygen therapy.

作者信息

Mofrad Pirooz, Choucair Wassim, Hulme Pamela, Moore Hans

机构信息

Division of Cardiology, Georgetown University, Veteran's Affairs Medical Center, 50 Irving Street, NW, Washington, DC 20422, USA.

出版信息

J Interv Card Electrophysiol. 2006 Aug;16(2):105-9. doi: 10.1007/s10840-006-9023-7. Epub 2006 Oct 11.

Abstract

We present a case of a 44 year-old man with medically refractory symptomatic paroxysmal atrial fibrillation in whom the initial attempt at left atrial catheter ablation was complicated by coronary and cerebral arterial air embolization during transseptal catheter exchange. The manifestations, management, and long term outcomes are detailed. Following the case report is a review of published reports and contemporary management strategies for treatment of acute air embolization. Dramatic clinical consequences can be aborted by prompt intervention including volume loading, oxygenation, lidocaine, and hyperbaric oxygen therapy.

摘要

我们报告一例44岁男性患者,患有药物治疗无效的症状性阵发性心房颤动,其在首次尝试进行左心房导管消融时,经房间隔导管更换过程中并发冠状动脉和脑动脉空气栓塞。详细介绍了其临床表现、处理方法及长期预后。病例报告之后是对已发表的关于急性空气栓塞治疗的报告及当代处理策略的综述。通过包括扩容、给氧、利多卡因和高压氧治疗在内的及时干预,可避免严重的临床后果。

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