title: Venous Air Embolism during Hysteroscopic Myomectomy: An Analysis of 7 Cases.
abstract: Venous air embolism (VAE) is a rare but potentially fatal complication of hysteroscopic myomectomy. The symptoms of VAE range from mild and clinically insignificant to complete cardiovascular collapse during surgery. Anesthesiologists and surgeons should be aware of the clinical characteristics and predisposing factors of this possible adverse event. This report analyzes 7 cases of VAE, which occurred at the University Hospitals Leuven, in patients undergoing hysteroscopic myomectomy from April 2009 to April 2011. Patient and myoma characteristics were compared to a control group of 27 patients who underwent uneventful hysteroscopic myomectomy during the same period of time. Analysis of baseline data including myoma size failed to identify predisposing factors. Clinical events in this series were classified according to their severity as minor (causing respiratory symptoms in 2 cases), moderate (accompanied by hemodynamic instability in 5 cases), or severe (requiring resuscitation in no cases). Case characteristics and therapeutic strategies in all cases were compared to reports from recent literature.
authors.affiliation: Department of Cardiovascular Sciences, KU Leuven, Department of Anesthesiology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Cédric
authors.initials: C
authors.lastname: Van Dijck
authors.forename: Steffen
authors.initials: S
authors.lastname: Rex
authors.forename: Jasper
authors.initials: J
authors.lastname: Verguts
authors.forename: Dirk
authors.initials: D
authors.lastname: Timmerman
authors.forename: Marc
authors.initials: M
authors.lastname: Van de Velde
authors.forename: An
authors.initials: A
authors.lastname: Teunkens
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D017548:Echocardiography, Transesophageal; D004618:Embolism, Air / Q000175:diagnosis* / Q000517:prevention & control; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects; D007431:Intraoperative Complications / Q000175:diagnosis / Q000517:prevention & control; D007889:Leiomyoma / Q000000981:diagnostic imaging / Q000601:surgery; D008875:Middle Aged; D011247:Pregnancy; D012189:Retrospective Studies; D063186:Uterine Myomectomy / Q000009:adverse effects* / Q000379:methods; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery
keywords: Complications; Hysteroscopic myomectomy; Hysteroscopy; Venous air embolism