Font V E, Gill C C, Lammermeier D E
Department of Cardiology, Cleveland Clinic Florida, Fort Lauderdale 33309.
Cleve Clin J Med. 1994 May-Jun;61(3):228-31. doi: 10.3949/ccjm.61.3.228.
Foreign bodies lodged in the heart can easily be missed during surgical repair of penetrating cardiac wounds.
We report the use of intraoperative echocardiography to identify and accurately locate a small cardiac foreign body. Our patient had a fragment of a drill bit lodged in his left atrium as the result of an industrial accident. He initially underwent emergency median sternotomy because of acute tamponade, but the foreign body was not found, and he subsequently required a second procedure to remove it. Intraoperative transesophageal and epicardial echocardiography during the second procedure confirmed the position of the metallic fragment, excluded the possibility of other lodged foreign particles, and ruled out other types of penetrating injury to the heart.
Intraoperative echocardiography should be standard procedure in the removal of intracardiac foreign bodies.
在穿透性心脏伤口的手术修复过程中，滞留在心脏内的异物很容易被遗漏。
我们报告了使用术中超声心动图来识别并准确定位一个小的心脏异物。我们的患者因工业事故导致一枚钻头碎片滞留在左心房。他最初因急性心包填塞接受了紧急正中胸骨切开术，但未发现异物，随后需要进行第二次手术来取出异物。第二次手术期间的术中经食管和心外膜超声心动图确定了金属碎片的位置，排除了其他滞留异物颗粒的可能性，并排除了心脏其他类型穿透性损伤。
术中超声心动图应成为取出心内异物的标准操作程序。
