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经胸超声心动图在法洛四联症根治术后体外循环脱机即刻发现心外管道内新血栓:病例报告。

New intra-conduit thrombus detected using transesophageal echocardiography immediately after weaning from cardiopulmonary bypass during the Fontan procedure: a case report.

机构信息

Osaka Women's and Children's Hospital, 840 Murodocho, Izumi, Osaka, Japan.

Kobe City Medical Center General Hospital, Kobe, Japan.

出版信息

J Anesth. 2023 Jun;37(3):482-486. doi: 10.1007/s00540-023-03195-3. Epub 2023 Apr 21.

Abstract

This study reports a case wherein a new thrombus was detected by transesophageal echocardiography in the conduit during extracardiac conduit Fontan procedure. Immediately after weaning from the cardiopulmonary bypass and administration of protamine, a thrombus was noted in the conduit by transesophageal echocardiography. Since the patient was hemodynamically stable, anticoagulation therapy was initiated after admission to the intensive care unit. One week post-surgery, imaging results showed residual thrombus, but the patient was safely discharged. Even during Fontan procedure, careful observation with transesophageal echocardiography is important because of the possibility of thrombus formation in the conduit.

摘要

本研究报告了一例在体外循环心外管道Fontan 手术中经食管超声心动图发现管道内新血栓的病例。在心肺转流脱机并给予鱼精蛋白后,经食管超声心动图发现管道内有血栓。由于患者血流动力学稳定,在入住重症监护病房后开始抗凝治疗。术后一周,影像学结果显示仍有血栓,但患者安全出院。即使在 Fontan 手术中,由于管道内可能形成血栓,也需要用经食管超声心动图进行仔细观察。

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