经食管超声心动图作为即将发生的矛盾栓塞的最后防御：一个病例报告。

IF 1.5 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiothoracic Surgery Pub Date : 2025-04-18 DOI:10.1186/s13019-025-03386-x

Zhuangyuan Chen, Mingjing Chen, Haibo Song, Yauwai Chan

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引用次数: 0

摘要

背景：即将发生的矛盾栓塞（IPDE）涉及静脉血栓穿过卵圆孔未闭，具有全身性栓塞的高风险。病例介绍：男性，64岁，因心衰症状入院，原计划行心房肿块切除二尖瓣置换术。术中经食管超声心动图（TEE）诊断为IPDE合并急性肺栓塞。这个关键的诊断立即改变了手术的决策过程，包括肺动脉血栓切除术。该病例的成功治疗很大程度上归功于术中TEE检查，它提供了必要的实时诊断信息，指导手术入路。本病例强调了术中TEE在IPDE手术计划管理中的重要性。结论：TEE是IPDE的最后防线。为了优化手术效果，避免误诊，强烈建议对类似病例进行术中TEE的常规应用。

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Transesophageal echocardiography as the final defense in impending paradoxical embolism: a case report.

Background: Impending paradoxical embolism (IPDE) involves venous thrombi crossing a patent foramen ovale, posing high risks of systemic embolization.

Case presentation: A 64-year-old male was admitted to the operation theater due to heart failure symptoms, with the original plan of undergoing atrial mass resection and mitral valve replacement. Intra-operative transesophageal echocardiography (TEE) diagnosed the patient with IPDE and acute pulmonary embolism. And this critical diagnosis immediately altered the surgical decision-making process, which included pulmonary artery thrombectomy. The successful treatment of this case was significantly attributed to the intraoperative TEE examination, which provided essential real-time diagnostic information guiding the surgical approach. This case highlighted the importance of intra-operative TEE in management of IPDE for surgical planning.

Conclusions: TEE is the final defense in IPDE. To optimize surgical outcomes and avert misdiagnosis, routine utilization of intraoperative TEE is highly recommended for similar cases.

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来源期刊

Journal of Cardiothoracic Surgery 医学-心血管系统

CiteScore

2.50

自引率

6.20%

发文量

286

审稿时长

4-8 weeks

期刊介绍： Journal of Cardiothoracic Surgery is an open access journal that encompasses all aspects of research in the field of Cardiology, and Cardiothoracic and Vascular Surgery. The journal publishes original scientific research documenting clinical and experimental advances in cardiac, vascular and thoracic surgery, and related fields. Topics of interest include surgical techniques, survival rates, surgical complications and their outcomes; along with basic sciences, pediatric conditions, transplantations and clinical trials. Journal of Cardiothoracic Surgery is of interest to cardiothoracic and vascular surgeons, cardiothoracic anaesthesiologists, cardiologists, chest physicians, and allied health professionals.