Acute pulmonary embolism(APE) in operation room is a constant,lethal but treatable disease.A fast determination of APE in an operation room is currently difficult due to a non-specificity on its signs,symptoms,electro...Acute pulmonary embolism(APE) in operation room is a constant,lethal but treatable disease.A fast determination of APE in an operation room is currently difficult due to a non-specificity on its signs,symptoms,electrocardiograph findings,arterial blood gas abnormalities and chest X-rays.Clinically,an APE can automatically originate from a small and clinically asymptomatic embolus to massive,proximal emboli with shock during a scheduled surgery period.An accurate,brief and prompt diagnostic and therapeutic strategy for APE in a peri-operation period is crucial for anesthesiologists to make a decision on an appropriate clinical intervention to improve patients' outcomes.The purpose of this mini-review article is to illuminate a fast-track diagnostic and therapeutic strategy for APE patients in a perioperative period through a hybrid of the high sensitive and high specific viable diagnostic modality of D-dimer assay in conjunction with necessary emergent pulmonary angiography(EPA),including digital subtraction angiography(DSA),or a spiral computed tomography angiography(sCTA) for APE patients' diagnosis and treatment during operation.The postulated fast-track diagnostic and therapeutic strategy can effectively confirm or exclude highly suspected APE and simultaneously provide fast therapeutic opportunities for APE patients at an operative period.展开更多
A 55-year-old man was admitted for transcatheter closure because of pulmonary arteriovenous fistula by magnetic resonance angiography （MRA）. He had a history of occasional chest pain more than one year. Angiography ...A 55-year-old man was admitted for transcatheter closure because of pulmonary arteriovenous fistula by magnetic resonance angiography （MRA）. He had a history of occasional chest pain more than one year. Angiography didn＇t reveal significant stenosis at coronary artery. The patient was found a continuous grade 2/6 murmur over the left upper parastenal area one month ago. Chest MRA revealed a possible left superior pulmonary arteriovenous fistula. For diagnosis and localization of the fistula, aortography and selective angiography of the intemal mammary artery was performed and presented a left internal mammary artery-to-pulmonary artery fistula. The fistula was successfully closed using an 12 mm domestic vascular plug. Chest MRA showed that the fistula disappeared at two-month follow-up展开更多
文摘Acute pulmonary embolism(APE) in operation room is a constant,lethal but treatable disease.A fast determination of APE in an operation room is currently difficult due to a non-specificity on its signs,symptoms,electrocardiograph findings,arterial blood gas abnormalities and chest X-rays.Clinically,an APE can automatically originate from a small and clinically asymptomatic embolus to massive,proximal emboli with shock during a scheduled surgery period.An accurate,brief and prompt diagnostic and therapeutic strategy for APE in a peri-operation period is crucial for anesthesiologists to make a decision on an appropriate clinical intervention to improve patients' outcomes.The purpose of this mini-review article is to illuminate a fast-track diagnostic and therapeutic strategy for APE patients in a perioperative period through a hybrid of the high sensitive and high specific viable diagnostic modality of D-dimer assay in conjunction with necessary emergent pulmonary angiography(EPA),including digital subtraction angiography(DSA),or a spiral computed tomography angiography(sCTA) for APE patients' diagnosis and treatment during operation.The postulated fast-track diagnostic and therapeutic strategy can effectively confirm or exclude highly suspected APE and simultaneously provide fast therapeutic opportunities for APE patients at an operative period.
文摘A 55-year-old man was admitted for transcatheter closure because of pulmonary arteriovenous fistula by magnetic resonance angiography （MRA）. He had a history of occasional chest pain more than one year. Angiography didn＇t reveal significant stenosis at coronary artery. The patient was found a continuous grade 2/6 murmur over the left upper parastenal area one month ago. Chest MRA revealed a possible left superior pulmonary arteriovenous fistula. For diagnosis and localization of the fistula, aortography and selective angiography of the intemal mammary artery was performed and presented a left internal mammary artery-to-pulmonary artery fistula. The fistula was successfully closed using an 12 mm domestic vascular plug. Chest MRA showed that the fistula disappeared at two-month follow-up
