Makita Satoru, Maruyama Toshiyuki
Division of Cardiovascular Surgery, Yokosuka Kyosai Hospital, Yokosuka, Japan.
Kyobu Geka. 2015 Aug;68(9):752-5.
The pulmonary artery catheter( PAC) has been used for hemodynamic monitoring in patients undergoing cardiac surgery. Pulmonary artery injury and pseudoaneurysm formation are the most serious and fatal complications of PAC. A 73-year-old female with aortic stenosis and angina underwent aortic valve replacement and coronary artery bypass grafting. PAC was inserted without difficulty before cardiac surgery in the operating room. The operation proceeded uneventfully. On the 1st postoperative day, massive hemoptysis suddenly occurred in the intensive care unit. The patient was treated with mechanical ventilation with positive end expiratory pressure. An enhanced computed tomography scan showed a pulmonary artery pseudoaneurysm, whith was successfully occluded by transcatheter arterial embolization. The patient was discharged in good health.
肺动脉导管（PAC）已被用于心脏手术患者的血流动力学监测。肺动脉损伤和假性动脉瘤形成是PAC最严重且致命的并发症。一名73岁患有主动脉瓣狭窄和心绞痛的女性接受了主动脉瓣置换术和冠状动脉搭桥术。在手术室进行心脏手术前，PAC的插入过程顺利。手术进展顺利。术后第1天，重症监护病房突然发生大量咯血。患者接受了呼气末正压通气的机械通气治疗。增强计算机断层扫描显示有肺动脉假性动脉瘤，通过经导管动脉栓塞成功将其闭塞。患者康复出院。
