Miyake Takahito, Obayashi Osamu, Kanda Akio, Okada Hideshi, Ogura Shinji, Kaneko Kazuo
Advanced Critical Care Center, Gifu University Hospital, Gifu-shi, Gifu, Japan (Dr. Miyake, Dr. Okada, and Dr. Ogura); the Department of Orthopaedic Surgery, Juntendo Shizuoka Hospital, Izunokuni, Shizuoka, Japan (Dr. Miyake, Dr. Obayashi, and Dr. Kanda); and the Department of Orthopaedic Surgery, Juntendo University, Bunkyo-ku, Tokyo, Japan (Dr. Kaneko).
J Am Acad Orthop Surg Glob Res Rev. 2019 Aug 6;3(8):e044. doi: 10.5435/JAAOSGlobal-D-19-00044. eCollection 2019 Aug.
A patent foramen ovale provides a portal through which a thrombus might pass from the right side of the circulation to the left. A 65-year-old man underwent high tibial osteotomy after the diagnosis of the right knee osteoarthritis. On postoperative day 12, he developed bilateral arm paresthesia. Enhanced CT revealed emboli in the bilateral pulmonary and subclavian arteries and deep vein thrombosis in the left lower limb. Transesophageal echocardiography after treatment revealed a patent foramen ovale during the Valsalva maneuver. It was thought that bilateral arm paresthesias were caused by the arterial emboli in the bilateral subclavian arteries.
卵圆孔未闭提供了一个血栓可能从循环系统右侧进入左侧的通道。一名65岁男性在被诊断为右膝骨关节炎后接受了高位胫骨截骨术。术后第12天，他出现双侧手臂感觉异常。增强CT显示双侧肺动脉和锁骨下动脉有栓子，左下肢有深静脉血栓形成。治疗后经食管超声心动图显示在瓦尔萨尔瓦动作时存在卵圆孔未闭。认为双侧手臂感觉异常是由双侧锁骨下动脉的动脉栓子引起的。
