A case in which transesophageal echocardiography was useful for the diagnosis and treatment of left main coronary trunk obstruction that suddenly developed during aortic replacement

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  • 人工血管置換術中に突然発症した左冠動脈主幹部閉塞の診断と治療に経食道心エコー検査が有用であった症例
  • ジンコウ ケッカン チカン ジュッチュウ ニ トツゼン ハッショウ シタ ヒダリ カンドウミャク シュカンブ ヘイソク ノ シンダン ト チリョウ ニ ケイ ショクドウシン エコー ケンサ ガ ユウヨウ デ アッタ ショウレイ

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Abstract

<p>　A 70's male patient underwent revision surgery for pseudoaneurysm at the anastomotic site of the ascending aorta graft. During the surgery, we experienced a drop in his blood pressure that did not respond to catecholamines. Transesophageal echocardiography (TEE) revealed regional wall motion abnormality (RWMA) on the anterior and anterolateral wall. We judged that myocardial ischemia requiring immediate revascularization was occurring. Furthermore, based on TEE, it was suspected that the cause of the myocardial ischemia was a blood flow disruption due to a thrombotic obstruction in the left main coronary trunk. Percutaneous coronary angioplasty (PCI) was performed to save his life. When RWMA occurs during surgery, TEE is useful for evaluating its distribution, estimating the culprit coronary artery and the cause of the RWMA, and evaluating the therapeutic effects, meaning that TEE plays an important role in saving the life of patients and their prognosis.</p>

Journal

  • Cardiovascular Anesthesia

    Cardiovascular Anesthesia 26 (1), 39-44, 2022-09-01

    Japanese Society of Cardiovascular Anesthesiologists

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