Chun Duk Hee, Chung Kum Hee, Lee Jong Yun, Song Ji Eun, Kim Jun Young, Lee Jung Hyang, Park Chunghyun
Department of Anesthesiology and Pain Medicine, CHA University School of Medicine, Pocheon, Korea.
Korean J Anesthesiol. 2009 Nov;57(5):633-636. doi: 10.4097/kjae.2009.57.5.633.
A 47-year-old woman was scheduled for mitral valvoplasty. Before induction of anesthesia, a pulmonary artery catheter (PAC) was placed via right internal jugular vein. Central venous pressure or right atrial pressure was traced until about 60 cm of PAC insertion and right ventricular pressure curve appeared without arrhythmias. We withdrew and advanced the catheter several times, but pressure tracing showed the same pattern. And we could not obtain the pulmonary artery pressure. We decided to leave the PAC in the right ventricle. No ventricular arrhythmia was detected. Postoperative chest x-ray revealed that PAC traveled through inferior vena cava and looped in the hepatic vein with the tip of the catheter in the right ventricle. Under fluoroscopic guidance, PAC was inserted to the pulmonary artery. No sign of hepatic vein obstruction was detected.
一名47岁女性计划进行二尖瓣成形术。在麻醉诱导前，经右颈内静脉放置了一根肺动脉导管（PAC）。在插入约60 cm PAC之前，记录中心静脉压或右心房压，随后出现右心室压力曲线且无心律失常。我们多次撤回并推进导管，但压力记录显示相同模式。并且我们未能获得肺动脉压力。我们决定将PAC留在右心室。未检测到室性心律失常。术后胸部X线显示，PAC经下腔静脉走行并在肝静脉内成袢，导管尖端位于右心室。在透视引导下，将PAC插入肺动脉。未检测到肝静脉阻塞迹象。
