Herbert James Taylor, Kertai Miklos David
1 Duke University Medical Center, Durham, NC, USA.
2 Vanderbilt University Medical Center, Nashville, TN, USA.
Semin Cardiothorac Vasc Anesth. 2018 Mar;22(1):100-103. doi: 10.1177/1089253217735912. Epub 2018 Jan 12.
The increasing use of endovascular interventions coupled with the large number of published case series detailing complications attest to the likelihood that anesthesiologists will encounter a case of intravascular foreign body embolization during their careers. Transesophageal echocardiography is essential to the diagnosis and management of traumatic and intravascular foreign bodies embolized to the heart because it can identify not only the foreign body but also hemodynamically significant lesions to radiolucent anatomic structures prior to and during surgical exploration. In this case presentation, we review how intraoperative transesophageal echocardiography facilitated the intraoperative assessment and management of a post-liver transplant patient who underwent open surgical removal of migrated inferior vena cava stent from the right ventricle with concomitant tricuspid valve annuloplasty.
血管内介入治疗的使用日益增加，再加上大量已发表的详细描述并发症的病例系列，这证明麻醉医生在其职业生涯中很可能会遇到血管内异物栓塞的病例。经食管超声心动图对于诊断和处理栓塞至心脏的创伤性和血管内异物至关重要，因为它不仅可以识别异物，还能在手术探查之前和期间识别对射线可透的解剖结构具有血流动力学意义的病变。在本病例报告中，我们回顾了术中经食管超声心动图如何有助于对一名肝移植术后患者进行术中评估和管理，该患者接受了开放手术，从右心室取出移位的下腔静脉支架，并同时进行了三尖瓣环成形术。
