[Paradoxical embolism during MIDCAB surgery].
A 36-year-old woman underwent MIDCAB surgery. During the exposure of LAD, the right ventricular wall was injured. The bleeding was controlled by compression. After that, she developed hypotension followed by cardiac arrest. At the same time, TEE showed bubbles in all of the right ventricle. The open chest massage and epinephrine 1 mg restored the heart beat. It was thought that bubbles were brought to the right ventricle via the injured wall by the blower. A few minutes after the cardiac arrest, bubbles were detected in the left atrium by TEE. This phenomenon was suspected as transpulmonary paradoxical embolism because no cardiac shunt could be detected by TEE.
Department of Anesthesiology, Nara Medical School, Nara 634-0813.
Yuri
Y
Karashima
Keiichi
K
Sha
Tomomi
T
Iwatsubo
Takashi
T
Shimoda
Toshinori
T
Horiuchi
Naoko
N
Kurita
Katsuyasu
K
Kitaguchi
Katsuji
K
Hirai
Hitoshi
H
Furuya
D000328:Adult; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000379:methods; D017548:Echocardiography, Transesophageal; D019320:Embolism, Paradoxical / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D006352:Heart Ventricles / Q000293:injuries; D006801:Humans; D007431:Intraoperative Complications; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects*