Saita Kosuke, Kariya Taro, Ezaka Mariko, Nakao Tatsuya, Kin Nobuhide
From the Departments of Anesthesia and Pain Relief Center, The University of Tokyo Hospital, Tokyo, Japan.
Departments of Anesthesiology.
A A Pract. 2020 Oct;14(12):e01321. doi: 10.1213/XAA.0000000000001321.
Bronchovenous fistula (BVF) associated with adult cardiac surgery is a rarely reported life-threatening condition. We present a 75-year-old woman who developed a BVF during cardiac surgery. Dense adhesion in the pleural and pericardial cavities was noted. Restrictive pulmonary pathology required high airway pressure. Transesophageal echocardiography and hemoglobin measurement were helpful for the timely diagnosis of BVF, which was controlled by transection of the right upper pulmonary vein where a vent catheter had been inserted. Injuries around the cannulated site presumably initiated the BVF, which was worsened by high-pressure ventilation. Therefore, cannulation site might be a risk factor for BVF.
与成人心脏手术相关的支气管静脉瘘(BVF)是一种罕见但危及生命的疾病。我们报告了一名75岁女性,她在心脏手术期间发生了BVF。术中发现胸膜腔和心包腔内有致密粘连。限制性肺部病变需要较高的气道压力。经食管超声心动图和血红蛋白测量有助于BVF的及时诊断,通过切断插入了通气导管的右上肺静脉来控制病情。插管部位周围的损伤可能引发了BVF,而高压通气使其恶化。因此,插管部位可能是BVF的一个危险因素。