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经皮猪尾导管置入术后左心室穿孔酷似前壁心肌梗死:一种罕见并发症

Left Ventricular Perforation Following Transcutaneous Pigtail Catheter Placement Mimicking Anterior Wall Myocardial Infarction: An Unusual Complication.

作者信息

Po Tien-Lung, Hung Huei-Fong, Yen Yu-Tong, Chuang Cheng-Yen

机构信息

Department of Internal Medicine Division of Cardiology Shin Kong Wu Ho-Su Memorial Hospital, Taipei Taiwan.

Shin Kong Wu Ho-Su Memorial Hospital Department of Internal Medicine Taipei Taiwan.

出版信息

J Acute Med. 2024 Sep 1;14(3):125-129. doi: 10.6705/j.jacme.202409_14(3).0004.

Abstract

In modern medical practice, procedures that involve the use of catheters are common. These procedures can range from percutaneous coronary and peripheral vascular interventions to using catheters to drain fluid. However, complications associated with catheter usage can arise, and the most severe one is the puncture of a vital organ due to catheter misplacement. In this case, we present a rare complication related to the use of a pigtail catheter, which caused perforation of the left ventricular free wall. The patient presented with an electrocardiogram showing ST segment elevation in the anterior wall, indicative of a heart attack. The patient underwent coronary angiography, which showed that the coronary arteries were unblocked. However, during the procedure, the medical team suspected that the pigtail catheter was stuck in the left ventricle chamber, based on the use of fluoroscopy. This suspicion was later confirmed using computer tomography. To address the issue, the patient underwent an emergent cardiorrhaphy, which was performed immediately. Fortunately, the patient survived the complication.

摘要

在现代医学实践中,涉及使用导管的操作很常见。这些操作范围从经皮冠状动脉和外周血管介入到使用导管引流液体。然而,与导管使用相关的并发症可能会出现,最严重的是由于导管误置导致重要器官穿孔。在此,我们呈现一例与猪尾导管使用相关的罕见并发症,该并发症导致左心室游离壁穿孔。患者心电图显示前壁ST段抬高,提示心脏病发作。患者接受了冠状动脉造影,结果显示冠状动脉未阻塞。然而,在操作过程中,医疗团队基于荧光透视怀疑猪尾导管卡在左心室腔,这一怀疑后来通过计算机断层扫描得到证实。为解决该问题,患者立即接受了紧急心脏修补术。幸运的是,患者从该并发症中存活下来。

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