Yamamoto T, Makuuchi H, Naruse Y, Kobayashi T, Goto M, Nonaka K
Department of Cardiovascular Surgery, Toranomon Hospital, Tokyo, Japan.
Jpn J Thorac Cardiovasc Surg. 1998 Nov;46(11):1162-7. doi: 10.1007/BF03217894.
We report a case of compartment syndrome caused by femoral arterial cannulation during cardiopulmonary bypass. A 62-year-old man who had been diagnosed as acute aortic dissection (type I) received a operation of partial arch replacement with reconstruction of brachiocephalic and left carotid arteries. Compartment syndrome was noticed just after the operation, which was caused by long-term ischemia during femoral arterial cannulation combined with poor collateral circulation by the dissection of iliac arteries. The emergency fascitomy was performed, therefore, he could be discharged without any complications. It is concluded that in case of acute aorte aortic dissection, the back-flow of blood should be checked at the time of femoral arterial cannulation, and whenever the back-flow is poor, some procedures should be added to increase distal blood flow.
我们报告一例体外循环期间股动脉插管引起的骨筋膜室综合征。一名62岁男性被诊断为急性主动脉夹层(I型),接受了部分主动脉弓置换术并重建头臂动脉和左颈动脉。术后立即发现骨筋膜室综合征,其由股动脉插管期间的长期缺血以及髂动脉夹层导致的侧支循环不良引起。因此进行了急诊筋膜切开术,患者得以无任何并发症出院。结论是,在急性主动脉夹层的情况下,股动脉插管时应检查血流情况,一旦血流不佳,应采取一些措施增加远端血流。