Case report: Cerebral air embolization in the electrophysiology laboratory during transseptal catheterization: curative treatment of acute left hemiparesis with prompt hyperbaric oxygen therapy.
We present a case of a 44 year-old man with medically refractory symptomatic paroxysmal atrial fibrillation in whom the initial attempt at left atrial catheter ablation was complicated by coronary and cerebral arterial air embolization during transseptal catheter exchange. The manifestations, management, and long term outcomes are detailed. Following the case report is a review of published reports and contemporary management strategies for treatment of acute air embolization. Dramatic clinical consequences can be aborted by prompt intervention including volume loading, oxygenation, lidocaine, and hyperbaric oxygen therapy.
Mofrad
Pirooz
P
Division of Cardiology, Georgetown University, Veteran's Affairs Medical Center, 50 Irving Street, NW, Washington, DC 20422, USA.
Choucair
Wassim
W
Hulme
Pamela
P
Moore
Hans
H
D000328:Adult; D001281:Atrial Fibrillation / Q000628:therapy; D017115:Catheter Ablation / Q000009:adverse effects*; D022062:Electrophysiologic Techniques, Cardiac / Q000009:adverse effects* / Q000379:methods; D004618:Embolism, Air / Q000209:etiology* / Q000628:therapy; D006801:Humans; D006931:Hyperbaric Oxygenation; D020766:Intracranial Embolism / Q000209:etiology* / Q000628:therapy; D007431:Intraoperative Complications / Q000628:therapy*; D008297:Male; D010291:Paresis / Q000209:etiology* / Q000628:therapy*