Ahsan Khalid, Hamid Mohammad, Fatimi Saulat, Hidayat Ijaz
Department of Anaesthesia, The Aga Khan University Hospital, Karachi.
Department of Cardiothoracic Surgery, The Aga Khan University Hospital, Karachi.
J Coll Physicians Surg Pak. 2014 Nov;24 Suppl 3:S166-8.
A 70 years old male underwent Coronary Artery Bypass and Graft (CABG) surgery. After induction, a Pulmonary Artery Catheter (PAC) was inserted via right IJV with some difficulty in achieving PA tracing. During distal RCA anastomosis, surgeon noticed PAC tip coming out of Right Ventricular (RV) surface. Resistance was felt on trying to pull PAC, so it was left there. Cardiac surgeon then opened the Right Atrium (RA) and pulled out the catheter. Multiple attempts during insertion of PA catheter should always raise the suspicion of PAC tip slipping back into the RV. It should be closely monitored during surgery and communicated to the surgeon.
一名70岁男性接受了冠状动脉旁路移植术（CABG）。诱导麻醉后，经右颈内静脉插入肺动脉导管（PAC），在获取肺动脉波形时遇到一些困难。在右冠状动脉远端吻合期间，外科医生注意到PAC导管尖端从右心室（RV）表面穿出。试图拔出PAC导管时感觉到有阻力，所以就留在了那里。心脏外科医生随后打开右心房（RA）并拔出了导管。在插入肺动脉导管过程中多次尝试时，应始终怀疑PAC导管尖端滑回右心室。手术期间应密切监测，并告知外科医生。
