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再次二尖瓣置换术后延迟性冠状动脉空气栓塞:一例报告

Delayed coronary air embolism post re-do mitral valve replacement: A case report.

作者信息

Nezafati Pouya, Yadav Sumit

机构信息

Townsville University Hospital, Townsville, Queensland Australia.

出版信息

ARYA Atheroscler. 2024;20(3):1-6. doi: 10.48305/arya.2024.41928.2910.

Abstract

BACKGROUND

Coronary air embolism (CAE) is a complication that can lead to catastrophic outcomes, including myocardial infarction, stroke, and death. It is reported to occur during cardiac catheterization, within a few hours after cardiac surgery, or as a result of chest trauma. This is a case report of delayed coronary air embolism following cardiac surgery.

CASE PRESENTATION

A 58-year-old female presented with New York Heart Association (NYHA) Class II symptoms resulting from severe, highly eccentric anterior mitral regurgitation from a bio-prosthetic valve. She had preserved ejection function and a total calcium score of zero. This patient underwent a re-do mechanical mitral valve replacement. Two days post-surgery, she was brought to the catheterization laboratory with signs and symptoms suggestive of an inferior myocardial infarction (MI) and complete heart block (CHB). Her symptoms and ST changes resolved immediately after the introduction of angiographic contrast. Angiography revealed no occlusion in the right coronary artery (RCA).

摘要

背景

冠状动脉空气栓塞(CAE)是一种可导致灾难性后果的并发症,包括心肌梗死、中风和死亡。据报道,它发生在心脏导管插入术期间、心脏手术后数小时内或胸部创伤后。这是一例心脏手术后延迟性冠状动脉空气栓塞的病例报告。

病例介绍

一名58岁女性因生物人工瓣膜导致严重、高度偏心的二尖瓣前叶反流出现纽约心脏协会(NYHA)II级症状。她的射血功能保留,总钙评分为零。该患者接受了再次机械二尖瓣置换术。术后两天,她因出现提示下壁心肌梗死(MI)和完全性心脏传导阻滞(CHB)的体征和症状被送往导管室。在注入血管造影剂后,她的症状和ST段改变立即消失。血管造影显示右冠状动脉(RCA)无闭塞。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b337/11651312/8f0cfbb255ee/ARYA-20-001-g001.jpg

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