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.
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.
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。
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