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经食管超声心动图在血管内栓塞异物诊断与处理中的应用

Transesophageal Echocardiography Use in Diagnosis and Management of Embolized Intravascular Foreign Bodies.

作者信息

Herbert James Taylor, Kertai Miklos David

机构信息

1 Duke University Medical Center, Durham, NC, USA.

2 Vanderbilt University Medical Center, Nashville, TN, USA.

出版信息

Semin Cardiothorac Vasc Anesth. 2018 Mar;22(1):100-103. doi: 10.1177/1089253217735912. Epub 2018 Jan 12.

Abstract

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.

摘要

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。

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