Nagasaka S, Taniguchi S, Kobayashi S, Kawata T, Mizuguchi K, Hirao Y, Kitamura S
Third Department of Surgery, Nara Medical College, Kashihara, Japan.
Heart Vessels. 1997;12(4):199-202. doi: 10.1007/BF02767048.
During left nephrectomy in a 35-year-old woman with a left renal cell carcinoma extending into the inferior vena cava (IVC) and right atrium, cardiac arrest occurred. Immediate transesophageal echocardiography demonstrated that the event was caused by a pulmonary tumor embolism. Emergent cardiopulmonary bypass (CPB) was established and the tumors in the pulmonary arteries were successfully removed. The left nephrectomy was completed. The patient recovered in the intensive care unit without any neurological deficit. A postoperative pulmonary perfusion scintigram showed no defect in the pulmonary circulation. Transesophageal echocardiography was useful for making a rapid diagnosis of an intraoperative pulmonary embolism originating from a tumor of the IVC or right atrium.
在一名35岁患有左肾细胞癌且肿瘤已延伸至下腔静脉（IVC）和右心房的女性患者进行左肾切除术期间，发生了心脏骤停。即时经食管超声心动图显示该事件是由肺肿瘤栓塞引起的。紧急建立了体外循环（CPB），肺动脉内的肿瘤被成功切除。左肾切除术完成。患者在重症监护病房康复，没有任何神经功能缺损。术后肺灌注闪烁扫描显示肺循环无缺损。经食管超声心动图有助于快速诊断术中源于IVC或右心房肿瘤的肺栓塞。
