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心房颤动患者脉冲消融过程中肺动脉异物取出术:一例报告

Removal of a pulmonary artery foreign body during pulse ablation in a patient with atrial fibrillation: A case report.

作者信息

Yan Rui, Lei Xin-Yu, Li Jun, Jia Liang-Liang, Wang Hai-Xiong

机构信息

Department of Cardiology, Shanxi Cardiovascular Hospital, Taiyuan 030000, Shanxi Province, China.

The CT Room of the Imaging Department, Shanxi Cardiovascular Hospital, Taiyuan 030000, Shanxi Province, China.

出版信息

World J Clin Cases. 2023 Sep 26;11(27):6587-6591. doi: 10.12998/wjcc.v11.i27.6587.

Abstract

BACKGROUND

Foreign bodies in the pulmonary circulation have been documented in the literature and are typically caused by interventional procedures. However, reports of pulmonary artery foreign bodies during femoral vein puncture are rare, and there is no description of this complication from the guidewire surface flows into the pulmonary artery during a pulse ablation in a patient with atrial fibrillation.

CASE SUMMARY

We described a case in which a linear foreign body suddenly appeared on fluoroscopy image during pulsed ablation of atrial fibrillation. Multiposition angiography showed that the foreign body was currently lodged in the pulmonary artery but was hemodynamically stable. We then chose to use an interventional approach to remove the foreign body from the pulmonary artery. This foreign body was subsequently confirmed to be from the hydrophilic coating of the guidewire surface. This may be related to the difficulties encountered during the puncture of the femoral vein. This is a rare and serious complication of femoral vein puncture. Therefore, we reported this case in order to avoid a similar situation.

CONCLUSION

Mismatches between interventional devices from different manufacturers used for femoral venipuncture may result in pulmonary artery foreign bodies.

摘要

背景

肺循环中的异物在文献中有记载,通常由介入操作引起。然而,股静脉穿刺期间肺动脉异物的报告很少,并且在房颤患者进行脉冲消融时,没有关于导丝表面血流进入肺动脉导致这种并发症的描述。

病例总结

我们描述了一例在房颤脉冲消融期间透视图像上突然出现线性异物的病例。多体位血管造影显示异物当前嵌顿在肺动脉,但血流动力学稳定。然后我们选择采用介入方法从肺动脉取出异物。该异物随后被确认为来自导丝表面的亲水涂层。这可能与股静脉穿刺时遇到的困难有关。这是股静脉穿刺罕见且严重的并发症。因此,我们报告此病例以避免类似情况。

结论

用于股静脉穿刺的不同厂家介入装置不匹配可能导致肺动脉异物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27a8/10601018/c2e290211eac/WJCC-11-6587-g001.jpg

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