Department of Cardiovascular Anaesthesia, Seth G.S.Medical College and K.E.M. Hospital, Mumbai, Maharashtra; Department of Anaesthesia and Intensive Care, Maulana Azad Medical College, New Delhi, India.
Department of Cardiovascular Anaesthesia, Seth G.S.Medical College and K.E.M. Hospital, Mumbai, Maharashtra, India.
Ann Card Anaesth. 2020 Oct-Dec;23(4):515-517. doi: 10.4103/aca.ACA_122_19.
Cardiac surgery involves use of cardiopulmonary bypass which usually requires a circulatory circuit containing numerous cannulae and tubings draining from major vessels (like superior and inferior vena cavae) and returning it back to the systemic circulation (via the aorta, femoral artery, axillary artery etc). Establishment of this circuit not only requires good surgical skills for technical procedures but also requires stringent vigilance and awareness about the working of these disposable items. Surgeons concentrating in the technical aspect might miss out on the minor manufacturing defects in these disposable items and anesthesiologist as well as perfusionist can contribute in this aspect by including systematic precheck of these items to avoid complications in future. In this case report, we would like to discuss a simple case of mitral valve replacement where during aortic decannulation the metallic tip got dislodged and thus got migrated to the abdominal aorta. This is a rare complication which none of us were expecting. By prechecking the various components of the cardiopulmonary bypass circuit, this complication was expected to be avoided.
心脏手术涉及心肺旁路的使用，通常需要一个包含许多插管和管道的循环回路，这些插管和管道从主要血管（如上腔静脉和下腔静脉）引流，并将其回流到体循环（通过主动脉、股动脉、腋动脉等）。建立这个回路不仅需要良好的手术技能来进行技术操作，还需要严格的警惕性和对这些一次性用品的工作原理的了解。专注于技术方面的外科医生可能会忽略这些一次性用品的微小制造缺陷，麻醉师和灌注师可以通过系统地检查这些用品来避免未来的并发症，从而在这方面做出贡献。在这个病例报告中，我们想讨论一个简单的二尖瓣置换病例，在主动脉拔管过程中，金属尖端脱落，从而迁移到腹主动脉。这是一种罕见的并发症，我们都没有预料到。通过对心肺旁路循环的各个组件进行预检，可以避免这种并发症。
