Lip Henry Tan Chor, Huei Tan Jih, Hamid Syed Rasul Bin G Syed, Vendargon Simon Jerome
Department of General Surgery, Faculty of Medicine, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia.
Clinical Research Centre, Hospital Sultan Ismail, Johor Bahru, Johor, Malaysia.
Saudi J Anaesth. 2018 Jul-Sep;12(3):462-464. doi: 10.4103/sja.SJA_674_17.
The prevalence of pulmonary artery catheter (PAC) entrapment in open-heart surgery is scarce with a prevalence rate of 0.065%. Challenges in managing such cases lie particularly in choosing the modalities (chest roentgenogram, fluoroscopy, and transesophageal echocardiography) to accurately identify the anatomic location and cause of entrapment. In this case, we report a 42-year-old man who underwent mitral valve replacement with PAC entrapment discovered on postoperative day 2 and subsequently underwent retrieval after re-sternotomy. This case also highlights the usefulness of transesophageal echocardiography by the cardiac anesthetist in aiding the surgeons to locate the anatomic location where the catheter was entrapped.
在心脏直视手术中,肺动脉导管(PAC)陷入的发生率很低,为0.065%。处理此类病例的挑战尤其在于选择合适的检查方式(胸部X线、荧光透视和经食管超声心动图)以准确识别陷入的解剖位置和原因。在此病例中,我们报告一名42岁男性,他在二尖瓣置换术后第2天发现有PAC陷入,随后在再次开胸术后取出导管。该病例还凸显了心脏麻醉医生进行经食管超声心动图检查在协助外科医生定位导管陷入的解剖位置方面的作用。