開心術における人工心肺使用中に肺動脈カテーテルによる右室穿孔を来した1症例

A Case of Right Ventricular Perforation Caused by a Pulmonary Artery Catheter during Cardiopulmonary Bypass in Cardiac Surgery

要旨

　70歳代女性に対して大動脈弁置換術と冠動脈バイパス術が行われ，人工心肺中に肺動脈カテーテルによる右室穿孔を生じた症例を経験した。本症例では高齢や組織の脆弱性などの右室損傷の危険因子を認めた。肺動脈カテーテルを使用する場合は十分な検討を行うことが重要である。

　Pulmonary artery catheters（PACs）are widely used as a hemodynamic monitoring tool during cardiac surgery. Although the use of a PAC provides valuable information for perioperative management, using a PAC is also associated with potentially serious complications, including pulmonary artery injury, pulmonary hemorrhage, and accidental suturing of the PAC. Due to these risks, a careful assessment of the indications and the appropriate handling of the PAC are essential. We report a rare but serious case of right ventricular perforation caused by a PAC during the cardiopulmonary bypass in a cardiac surgery.