Poffo Robinson, Louzada Andressa Cristina Sposato, Curcio Sergio Augusto Fudaba, Teivelis Marcelo Passos, Wolosker Nelson
Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Einstein (Sao Paulo). 2024 Nov 29;22:eRC0943. doi: 10.31744/einstein_journal/2024RC0943. eCollection 2024.
A 42-year-old female patient with a surgical history of iliac venous angioplasty with stenting developed dyspnea on exertion 9 months later. Chest computed tomography angiography revealed a fractured vascular stent in the right cardiac chamber. Doppler echocardiography confirmed that the stent was anchored by the tricuspid valve, causing mild obstruction of the right ventricular filling. The patient underwent robot-assisted cardiac surgery with stent removal, annuloplasty under general anesthesia, and cardiopulmonary bypass via an axillary incision. No sternotomy, cardioplegia, or aortic clamping was required. The right atrium was opened, and no surgical or anesthetic complications occurred. The patient was extubated in the operating room, with no requirement for vasoactive drugs after surgery. She was discharged on the fifth postoperative day in a good general condition, eupneic, and without lower-limb venous symptoms. Re-do iliac venous angioplasty was not necessary.
一名42岁女性患者，有髂静脉血管成形术加支架置入的手术史，9个月后出现劳力性呼吸困难。胸部计算机断层扫描血管造影显示右心腔内有一个断裂的血管支架。多普勒超声心动图证实该支架被三尖瓣固定，导致右心室充盈轻度受阻。患者在全身麻醉下接受了机器人辅助心脏手术，取出支架，进行瓣环成形术，并通过腋窝切口进行体外循环。无需开胸、心脏停搏或夹闭主动脉。打开右心房，未发生手术或麻醉并发症。患者在手术室拔管，术后无需使用血管活性药物。她于术后第五天出院，一般情况良好，呼吸正常，无下肢静脉症状。无需再次进行髂静脉血管成形术。
