文章基本信息

标题：The Auscultation of a Carbon Dioxide Embolization Event during Endoscopic Vein Harvest
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作者：Erik Strauss ; Bradley Taylor ; Michael Mazzeffi 等
期刊名称：Case Reports in Anesthesiology
印刷版ISSN：2090-6382
出版年度：2016
卷号：2016
DOI：10.1155/2016/6947679
出版社：Hindawi Publishing Corporation
摘要：Endoscopic vein harvest in preparation for coronary artery bypass surgery has become a preferred method of procuring saphenous vein. Several case reports have documented carbon dioxide (CO2) embolization with this procedure as well as CO2 embolization during other laparoscopic surgeries (Markar et al., 2010). Although uncommon, the potential for CO2 entrainment through an open vein or through absorption by vascular structures exists and should be recognized (Lin et al., 2003). We report a case of CO2 embolization during EVH for a 77-year-old patient who underwent CABG that was identified early by the cardiac surgeon through the indirect auscultation of a mill-wheel murmur after the pericardium was opened. This may be the first reported case of a murmur related to air emboli identified without the use of a precordial Doppler probe or a stethoscope. This diagnosis was further supported by TEE before systemic hypotension or cardiovascular collapse occurred.