Guo-Cao Wang, Xi-Rong Li, Ning Huang, Hai-Tao Tian
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引用次数: 0
摘要
背景:先天性心包缺失(CAP)是一种罕见的心脏畸形。由于心包缺损通常没有症状,大多数病例都是在手术或尸检时被诊断出来的。本病例中的患者在胸腔镜检查时被发现患有 CAP:本病例是一例不寻常的病例,69 岁的 CAP 患者在进行左上肺叶切除术时突发室性心律失常并发展为心室颤动。手术操作、侧卧位和其他外部刺激可能是室颤的重要危险因素。经过胸腔内心脏加压和药物治疗(包括在心脏表面喷洒利多卡因(2%,10 毫升))后,患者很快恢复了窦性心律。随后,手术顺利完成,未再发生室性心律失常:结论:CAP 患者在进行开胸手术或胸腔镜手术时更容易发生与心脏相关的不良事件。结论:CAP 患者在胸廓切开术或胸腔镜手术中更容易发生与心脏相关的不良事件,因此应重视治疗 CAP 患者在肺切除术中出现的室性心律失常。
Sudden ventricular fibrillation due to absence of pericardium in left upper lobectomy -a case report.
Background: Congenital absence of the pericardium (CAP) is a rare cardiac abnormality. As pericardial defects are usually asymptomatic, most cases are diagnosed during surgery or on autopsy. The patient in this case was found to have CAP during thoracoscope.
Case: We present the unusual case of a 69-year-old patient with CAP who experienced sudden ventricular arrhythmia and developed ventricular fibrillation during left upper lobectomy. Surgical operations, the lateral decubitus position, and other external stimuli may be important risk factors for ventricular fibrillation. The patient regained sinus rhythm soon after intrathoracic cardiac compression and pharmacological treatment, including lidocaine spray (2%, 10 ml) administered to the heart surface. The surgery was then completed without any additional instances of ventricular arrhythmia.
Conclusions: Patients with CAP are more susceptible to cardiac-related adverse events during thoracotomy or thoracoscopy. Treatment of ventricular arrhythmias that occur during lung resection in patients with CAP should be emphasized.