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透析后罕见的医源性心血管栓塞

Rare Iatrogenic Cardiovascular Embolization Following Dialysis.

作者信息

Sharma Arun, Duraisamy Sharmila, Jagia Priya, Gulati Gurpreet S

机构信息

1 Department of Cardiac Radiology, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Vasc Endovascular Surg. 2017 Jan;51(1):33-35. doi: 10.1177/1538574416682173. Epub 2016 Dec 14.

Abstract

Intracardiac or intrapulmonary dislodgement of dialysis catheter or guidewire coating is extremely rare. When present, it can be potentially lethal as it may get complicated by arrhythmias, myocardial or pulmonary artery rupture, valvular perforation, pulmonary thromboembolism, infarction, and infective endocarditis. Percutaneous removal should be attempted as an initial measure and is usually effective in most of the cases. We report 2 such cases, where in first patient it was the hemodialysis catheter which broke, with a large part migrating into the heart, while in second patient, it was the hydrophilic coating of the guidewire that migrated into the pulmonary arteries. Percutaneous retrieval of these foreign bodies was done successfully in both the cases.

摘要

透析导管或导丝涂层的心内或肺内移位极为罕见。一旦发生,可能会危及生命,因为它可能会并发心律失常、心肌或肺动脉破裂、瓣膜穿孔、肺血栓栓塞、梗死和感染性心内膜炎。应尝试将经皮取出作为初始措施,并且在大多数情况下通常有效。我们报告2例这样的病例,第一例患者是血液透析导管断裂,大部分导管移入心脏,而第二例患者是导丝的亲水涂层移入肺动脉。两例均成功经皮取出这些异物。

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