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心脏停搏伴心脏压塞致经皮房间隔缺损封堵术后 6 年:1 例抢救成功病例报告。

A life-saving case of cardiopulmonary arrest with cardiac tamponade caused by erosion 6 years after percutaneous atrial septal defect closure: a case report.

机构信息

Cardiovascular Surgery, Japanese Red Cross Kyoto Daini Hospital, 355-5 Haruobi-cho, Kamanzadori, Marutamachi-agaru, Kamigyo-ku, Kyoto, 602-8026, Japan.

Department of Primary Care and Emergency Medicine, Graduate School of Medicine, Kyoto, Japan.

出版信息

J Cardiothorac Surg. 2021 May 21;16(1):137. doi: 10.1186/s13019-021-01537-4.

DOI:10.1186/s13019-021-01537-4
PMID:34020682
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8139088/
Abstract

BACKGROUND

Cardiac erosion after percutaneous atrial septal defect (ASD) closure is a rare complication that requires immediate life-saving emergency surgery. In this report, we present our successful life-saving strategy for cardiac arrest due to cardiac tamponade caused by erosion 6 years after the percutaneous closure of an ASD.

CASE PRESENTATION

The patient was a 50-year-old man who received treatment using an Amplatzer septal occluder (St. Jude Medical, St. Paul, MN, USA) treatment for ostium secundum atrial septal defect (size: 29.5 × 27.0 mm) at another institution when he was 44 years old.

CONCLUSIONS

This case report presents a bailout surgical strategy for patients who are hemodynamically unstable with risks of coagulopathy and multiple organ failure. This case shows that cardiac surgeons need to be aware of percutaneous ASD-closure complications and should consider a bailout surgical strategy for patients at risk of multiple organ failure.

摘要

背景

经皮房间隔缺损(ASD)封堵术后发生心脏侵蚀是一种罕见的并发症,需要立即进行救生紧急手术。在本报告中,我们介绍了我们成功的救生策略,用于治疗因 6 年前经皮 ASD 封堵术后侵蚀导致心脏压塞而引起的心脏骤停。

病例介绍

患者为 50 岁男性,44 岁时在另一家机构使用 Amplatzer 房间隔封堵器(圣犹达医疗公司,明尼苏达州圣保罗,美国)治疗继发孔型房间隔缺损(大小:29.5×27.0mm)。

结论

本病例报告介绍了一种用于血流动力学不稳定、伴有凝血功能障碍和多器官衰竭风险患者的抢救性外科策略。本病例表明,心脏外科医生需要意识到经皮 ASD 封堵术的并发症,并应为有发生多器官衰竭风险的患者考虑抢救性外科策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/467c/8139088/fe35ef092029/13019_2021_1537_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/467c/8139088/bec6c418a94e/13019_2021_1537_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/467c/8139088/fe35ef092029/13019_2021_1537_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/467c/8139088/bec6c418a94e/13019_2021_1537_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/467c/8139088/fe35ef092029/13019_2021_1537_Fig2_HTML.jpg

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Survival After Cardiac Arrest With Instantaneous Rigorlike Stiffness: A Case Report.心搏骤停后即刻出现僵直样僵硬的存活:一例报告。
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Investigation of complications secondary to chest compressions before and after the 2010 cardiopulmonary resuscitation guideline changes by using multi-detector computed tomography: a retrospective study.
使用多排螺旋计算机断层扫描对2010年心肺复苏指南变更前后胸外按压继发并发症的调查:一项回顾性研究
Scand J Trauma Resusc Emerg Med. 2017 Jan 26;25(1):8. doi: 10.1186/s13049-017-0352-6.
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Relative Risk Factors for Cardiac Erosion Following Transcatheter Closure of Atrial Septal Defects: A Case-Control Study.经导管封堵房间隔缺损后心脏侵蚀的相关危险因素:一项病例对照研究。
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Frequency and number of resuscitation related rib and sternum fractures are higher than generally considered.与复苏相关的肋骨和胸骨骨折的发生率及数量高于普遍认知。
Resuscitation. 2015 Aug;93:136-41. doi: 10.1016/j.resuscitation.2015.02.034. Epub 2015 Mar 12.
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7
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Semin Cardiothorac Vasc Anesth. 2014 Jun;18(2):161-76. doi: 10.1177/1089253214532375.
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