Yamanaka K, Miki S, Kusuhara K, Ueda Y, Okita Y, Tahata T
Heart Center, Hyogo Kenritsu Amagasaki Hospital, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1994 Oct;42(10):1940-3.
An urgent pulmonary embolectomy on a patient under intraoperative angioscopy for the treatment of massive pulmonary embolism was performed and successfully saved the patient. The case was a 19-year-old man who had been bedridden over along period of time. He developed pulmonary embolism immediately after the initiation of walking rehabilitation. Although anticoagulation therapy was immediately carried out, hemodynamics deteriorated, and as a result, it became necessary to treat this patient with the urgent surgical procedure. Under extracorporeal circulation with the clamping of the aorta, the pulmonary artery was opened. Following embolectomy for the left pulmonary artery, the right pulmonary artery, where the presence of clots had not been confirmed with the naked eye, was inspected using an flexible fiberoptic choledochoscope 4.9 mm in diameter. Consequently, amount of clots were removed using forceps or an aspirating tube. The patient recovered from hypoxemia after surgery. The use of intraoperative angioscopy in the pulmonary artery proved to be very useful to examine the presence of emboli up to tertiary branches of pulmonary artery.
对一名在术中血管镜检查下接受紧急肺动脉血栓切除术以治疗大面积肺栓塞的患者进行了手术，并成功挽救了该患者。该病例为一名长期卧床的19岁男性。他在开始步行康复后立即发生了肺栓塞。尽管立即进行了抗凝治疗，但血流动力学仍恶化，因此有必要对该患者进行紧急外科手术治疗。在体外循环并夹住主动脉的情况下，打开肺动脉。在对左肺动脉进行血栓切除术后，使用直径4.9毫米的柔性纤维胆道镜检查肉眼未确认有血栓的右肺动脉。随后，用镊子或吸引管清除了大量血栓。患者术后从低氧血症中康复。事实证明，术中血管镜检查在肺动脉中的应用对于检查直至肺动脉三级分支的栓子非常有用。
