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栓塞导丝进入主动脉中部:儿科重症监护病房的一场噩梦。

Embolized Guidewire into Central Aorta: A Nightmare in the Pediatric Intensive Care Unit.

作者信息

Nath R K, Agrawal Richa, Sarowa Manoj, Pandit Neeraj

机构信息

Department of Cardiology, Ram Manohar Lohia Hospital, New Delhi, Delhi.

出版信息

J Pediatr Intensive Care. 2018 Dec;7(4):210-212. doi: 10.1055/s-0038-1646779. Epub 2018 Apr 29.

Abstract

A 4-month-old preterm, critically ill infant weighing 3.8 kg was admitted to our pediatric intensive care unit with congestive cardiac failure due to a large ventricular septal defect and its sequelae. During an attempt to insert a central line into the right subclavian vein at bedside, the guidewire inadvertently entered the subclavian artery and embolized distally. After multiple failed retrieval attempts, including surgical femoral cut-down to retrieve the wire, it was removed finally by fluoroscopic-guided percutaneous catheterization with the help of a cardiac bioptome and a gooseneck snare utilizing a novel maneuver.

摘要

一名4个月大的早产重症婴儿,体重3.8千克,因大型室间隔缺损及其后遗症导致充血性心力衰竭,被收治入我们的儿科重症监护病房。在床边尝试将中心静脉导管插入右锁骨下静脉时,导丝意外进入锁骨下动脉并向远端栓塞。经过多次取回尝试均失败,包括通过外科股动脉切开术取回导丝,最终在心脏活检钳和鹅颈圈套器的帮助下,利用一种新的操作方法,通过透视引导下经皮导管插入术将其取出。

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