漏斗胸Nuss修复术中无心脏器质性损伤的心脏骤停
Cardiac arrest without physical cardiac injury during Nuss repair of pectus excavatum.
作者信息
Zou Jianyong, Luo Canqiao, Liu Zhenguo, Cheng Chao
机构信息
Department of Thoracic Surgery, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China.
Department of Pathology, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China.
出版信息
J Cardiothorac Surg. 2017 Jul 24;12(1):61. doi: 10.1186/s13019-017-0624-2.
BACKGROUND
Cardiac arrest is a lethal complication of Nuss repair of pectus excavatum which is strongly related to heart or big vessels injury. A rare case developed cardiac arrest without direct cardiac injury during Nuss procedure is presented in this article.
CASE PRESENTATION
In July 2015, a previously healthy 18-year-old man undergoing Nuss repair for pectus excavatum developed cardiac arrest while the Nuss bar was being inserted into the chest. After successful resuscitation and exclusion of direct cardiac injury, the Nuss procedure was continued. The patient suffered a second cardiac arrest during rotation of the Nuss bar. This time, the patient had poor initial response to resuscitation and defibrillation until the retrosternal bar was removed. He ultimately recovered well from the episodes of cardiac arrest, but was unable to receive surgical correction of his pectus excavatum deformity.
CONCLUSIONS
The possible mechanisms of cardiac arrest and lessons we can learn from this complication are discussed.
背景
心脏骤停是漏斗胸Nuss修复术的一种致命并发症，与心脏或大血管损伤密切相关。本文报告1例在Nuss手术期间未发生直接心脏损伤却出现心脏骤停的罕见病例。
病例报告
2015年7月，一名既往健康的18岁男性在接受漏斗胸Nuss修复术时，在将Nuss钢板插入胸部过程中发生心脏骤停。成功复苏并排除直接心脏损伤后，继续进行Nuss手术。在旋转Nuss钢板时，患者再次发生心脏骤停。此次，患者在复苏和除颤初期反应不佳，直到胸骨后钢板被取出。他最终从心脏骤停发作中恢复良好，但未能接受漏斗胸畸形的手术矫正。
结论
讨论了心脏骤停的可能机制以及我们可从该并发症中吸取的教训。
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