A case of successful cardiac catheterization for coronary air embolism developed after pleural lavage for chronic empyema

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  • Katagiri Shinobu
    Department of Thoracic Surgery, Saku Central Hospital Advanced Care Center
  • Endoh Hideki
    Department of Thoracic Surgery, Saku Central Hospital Advanced Care Center
  • Tachibana Takahiro
    Department of Cardiovascular Medicine, Saku Central Hospital Advanced Care Center
  • Nishizawa Nobuhiro
    Department of Thoracic Surgery, Saku Central Hospital Advanced Care Center
  • Satoh Yukitoshi
    Department of Thoracic Surgery, Kitasato University School of Medicine
  • Yamamoto Ryohei
    Department of Thoracic Surgery, Saku Central Hospital Advanced Care Center

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  • 慢性膿胸に対する胸腔内洗浄後の冠動脈空気塞栓に心臓カテーテル治療が奏功した1例

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Abstract

<p>A 77-year-old man who had chronic empyema after thoracoscopic left upper lobectomy had been treated with thoracic drainage and pleural lavage. Thirty months after surgery, just after finishing pleural lavage with saline solution in an outpatient setting, the patient suddenly lost consciousness and fell into a state of shock. We diagnosed him with coronary air embolism because ECG showed ST elevation and echocardiography and chest CT showed air in vessels, and cardiac catheterization was performed emergently. Air existed in the ascending aorta and right coronary artery, and the patient's condition recovered after aspirating the air with a cardiac catheter. Although he developed mild cerebral air embolism, he improved by conservative treatment and rehabilitation, and was finally discharged. Although there are some reports of air embolism caused by pleural lavage for chronic empyema, the mechanism of how it occurs remains unknown. This case suggests the usefulness of cardiac catheterization for air embolism, since a severe condition could be prevented in the present case by aspirating a large amount of air in vessels with a cardiac catheter.</p>

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