Fatal left atrial air embolism as a complication of percutaneous transthoracic lung biopsy: A case report |
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Authors: | Yi-Wei Li Can Chen Ying Xu Qian-Ping Weng Shen-Xian Qian |
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Affiliation: | Yi-Wei Li, Qian-Ping Weng, Department of Critical Care Medicine, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, ChinaCan Chen, Ying Xu, Shen-Xian Qian, Department of Hematology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China |
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Abstract: | BACKGROUNDComputed tomography (CT)-guided percutaneous lung biopsy is a common protocol in the context of diagnostic thoracic oncology, but entails a risk of complications including systematic air embolism (SAE). While SAE is often well tolerated, it can be difficult to treat and may result in rapid mortality in some cases.CASE SUMMARYWe report a rare case of left atrial SAE in a 71-year-old woman who underwent a CT-guided lung biopsy of a pulmonary nodule in the posterior basal segment of the right lower lobe. Shortly following needle extraction, she experienced a mild cough, hemoptysis, rapid-onset unconsciousness, and cardiopulmonary arrest. Cardiopulmonary resuscitation was immediately performed, but the patient died 40 min after the procedure. A closer review of collected CT scans revealed the presence of a large volume of air within the left atrium.CONCLUSIONAlthough SAE is generally well tolerated and asymptomatic, interventional radiologists must be aware of the risk of fatal outcomes and establish appropriate emergency management protocols. In this report, the characteristics, mechanisms, and treatment recommendations associated with SAE are discussed in an effort to improve the survival of affected patients. |
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Keywords: | Systematic air embolism Computed tomography-guided lung biopsy Bronchovenous fistula Risk-factors Emergency intervention Case report |
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