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肺动脉导管误入左心室：一例报告

Malposition of a pulmonary artery catheter in the left ventricle: a case report.

作者信息

Nakanishi Toshiyuki, Kato Shohei, Tamura Tetsuya, Kako Eisuke, Sobue Kazuya

机构信息

Department of Anesthesiology and Intensive Care Medicine, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Japan.

出版信息

JA Clin Rep. 2023 May 24;9(1):29. doi: 10.1186/s40981-023-00622-y.

DOI:10.1186/s40981-023-00622-y
PMID:37222884
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10209354/
Abstract

BACKGROUND

Placement of pulmonary artery catheters may be associated with a variety of complications. We present a case where a pulmonary artery catheter was accidentally advanced into the left ventricle by perforating the intraventricular septum.

CASE PRESENTATION

A 73-year-old woman underwent mitral valve dysfunction. A pulmonary artery catheter could not pass the tricuspid valve under general anesthesia, which was manually advanced via the right ventricle during surgery. After valve replacement, systolic pulmonary artery pressure was higher than radial arterial blood pressure. Transesophageal echocardiography (TEE) revealed the tip of the catheter in the left ventricle. The catheter was withdrawn and then advanced to the pulmonary artery under monitoring of TEE. Transseptal shunt flow gradually decreased and finally disappeared. The surgery was completed without additional procedures.

CONCLUSIONS

Although ventricular septal perforation is rare, it should be recognized as a potential complication of pulmonary artery catheter insertion.

摘要

背景

肺动脉导管置入可能与多种并发症相关。我们报告一例肺动脉导管意外穿破室间隔进入左心室的病例。

病例报告

一名73岁女性接受二尖瓣功能不全手术。在全身麻醉下肺动脉导管无法通过三尖瓣，术中通过右心室手动推进。瓣膜置换术后，收缩期肺动脉压高于桡动脉血压。经食管超声心动图（TEE）显示导管尖端位于左心室内。导管被撤回，然后在TEE监测下推进至肺动脉。经间隔分流逐渐减少并最终消失。手术顺利完成，未进行额外操作。

结论

尽管室间隔穿孔罕见，但应将其视为肺动脉导管插入术的潜在并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36b7/10209354/f7973126045b/40981_2023_622_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36b7/10209354/bcfb7c595357/40981_2023_622_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36b7/10209354/63882d40b7f9/40981_2023_622_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36b7/10209354/f7973126045b/40981_2023_622_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36b7/10209354/bcfb7c595357/40981_2023_622_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36b7/10209354/63882d40b7f9/40981_2023_622_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36b7/10209354/f7973126045b/40981_2023_622_Fig3_HTML.jpg

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