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Transesophageal echocardiography used for transvenous pacemaker implantation in a patient with cardiac tumors: a case report

DOI

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Other Title
  • 巨大心臓腫瘍に対する経静脈的ペースメーカー植え込み術において,経食道心エコーが術中麻酔管理とリード留置に有用であった一例
  • 症例報告 巨大心臓腫瘍に対する経静脈的ペースメーカー植え込み術において,経食道心エコーが術中麻酔管理とリード留置に有用であった一例
  • ショウレイ ホウコク キョダイ シンゾウ シュヨウ ニ タイスル ケイ ジョウミャクテキ ペースメーカー ウエコミ ジュツ ニ オイテ,ケイ ショクドウシン エコー ガ ジュッチュウ マスイ カンリ ト リード リュウチ ニ ユウヨウ デ アッタ イチレイ

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Abstract

<p> In this report, we describe the case of a patient with a massive primary cardiac malignant lymphoma who underwent anesthetic management for transvenous pacemaker implantation, which was safely performed using combined transesophageal echocardiography (TEE) and fluoroscopy intraoperatively with pacing lead placement guided by echocardiography.</p><p> A 71 year-old male was diagnosed with a massive cardiac malignant lymphoma. The tumor occupied the right atrium and ventricle, as well as the vena cava. Electrocardiography revealed a complete atrioventricular block. Elective pacemaker implantation under general anesthesia was planned. General anesthesia was carefully introduced with extracorporeal circulation on stand-by in case of collapsed circulation.</p><p> Intraoperatively, guiding the pacing lead to the proper position was difficult for the cardiovascular surgeon. The anesthesiologist then suggested the use of TEE for guiding the pacing lead. Subsequently, the pacing lead was successfully placed in the appropriate position by a combination of TEE guidance and fluoroscopy without any cardiovascular complications.</p><p> TEE guidance may be considered feasible and efficient for transvenous pacemaker implantation under general anesthesia.</p>

Journal

  • Cardiovascular Anesthesia

    Cardiovascular Anesthesia 24 (1), 173-177, 2020-08-01

    Japanese Society of Cardiovascular Anesthesiologists

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