经胸超声心动图监测 CO2 气腹食管内镜诊断房-食管瘘并预防医源性空气栓塞：一例报告。
Transthoracic echocardiography-monitored CO-insufflation esophageal endoscopy for diagnosis of Atrioesophageal fistula and prevention of iatrogenic air embolism: a case report.
机构信息
The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission, and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Qilu Hospital of Shandong University, 107 Wenhuaxi Road, Jinan, 250012, China.
Department of Geriatric Medicine, Qilu Hospital of Shandong University, 107 Wenhuaxi Road, Jinan, 250012, China.
出版信息
BMC Cardiovasc Disord. 2020 May 12;20(1):219. doi: 10.1186/s12872-020-01503-3.
BACKGROUND
Atrioesophageal fistula (AEF) is the most fatal complication associated with catheter ablation for atrial fibrillation and cannot be easily detected when thoracic contrast-enhanced computed tomography (CT) is normal.
CASE PRESENTATION
In this report, we described a diagnostic tool for detecting AEF with doubtful chest CT in which we introduced CO-insufflation esophageal endoscopy with transthoracic echocardiography monitoring. Using this modified esophageal endoscopy, AEF was established due to the presence of both esophageal lesions and bubbles into the left atrium. That way, our patient accepted to be operated in time with good clinical prognosis.
CONCLUSIONS
This modified esophageal endoscopy is an alternative tool for early detection of AEF when normal or doubtful CT findings present.
背景
房-食管瘘（AEF）是与房颤导管消融相关的最致命的并发症，当胸部增强 CT 正常时，它不易被发现。
病例介绍
在本报告中，我们描述了一种诊断工具，用于在胸部 CT 结果可疑的情况下检测 AEF，我们引入了经胸超声心动图监测下 CO 气腹食管内镜检查。使用这种改良的食管内镜检查，由于食管病变和气泡进入左心房，确立了 AEF 的诊断。通过这种方式，我们的患者及时接受了手术治疗，临床预后良好。
结论
当 CT 正常或结果可疑时，这种改良的食管内镜检查是早期发现 AEF 的一种替代工具。
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