| A case of Takayasu arteritis complicated by right atrium perforation and injuries of the right common iliac artery and vein caused by cannulation for percutaneous cardiopulmonary support. | |
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MedLine Citation:
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PMID: 19949317 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We describe an autopsy case of Takayasu arteritis with right atrium perforation and injuries of the right common iliac artery and vein caused by cannulation for percutaneous cardiopulmonary support (PCPS). The decedent was an 8-year-old girl admitted for examination in respect to chest pain and syncope. During catheter angiography, she suddenly went into cardiac arrest. PCPS was attempted, whereupon bleeding into the abdominal cavity and an injury to the common iliac vein were observed. She was pronounced dead 78 hours after the initiation of PCPS. Autopsy revealed thickening of the aortic wall from the ascending aorta to the abdominal aorta, with narrowing of the proximal branches. Hemopericardium induced by right atrium perforation, and an injury of the right common iliac artery, were also found. Microscopic examinations of the aorta disclosed thickening of each layer of the vessel wall and inflammatory cell infiltration, mainly into the outer layer of the media. It was speculated that manipulation of the catheter and the underlying Takayasu arteritis caused cardiac arrest. It is also considered that hypovolemia was induced by the injuries of the right common iliac artery and vein caused during the insertion of the PCPS venous cannula. In addition, the right atrium was injured by the edge of the PCPS cannula, leading to hemopericardium. In pediatric cases involving PCPS, or in cases where cannulation is difficult, regular examination of the pericardial and abdominal cavities by echocardiography would provide useful information to prevent such accidents. |
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Authors:
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Masataka Takamiya; Sachiko Fujita; Hisae Niitsu; Yasuhiro Aoki; Hiroyuki Kanno; Takashi Sawai |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: The American journal of forensic medicine and pathology Volume: 31 ISSN: 1533-404X ISO Abbreviation: Am J Forensic Med Pathol Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-02-24 Completed Date: 2010-06-10 Revised Date: 2011-02-02 |
Medline Journal Info:
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Nlm Unique ID: 8108948 Medline TA: Am J Forensic Med Pathol Country: United States |
Other Details:
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Languages: eng Pagination: 72-6 Citation Subset: IM |
Affiliation:
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Department of Legal Medicine, Iwate Medical University School of Medicine, Morioka, Iwate, Japan. mtakamiy@iwate-med.ac.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cardiopulmonary Bypass
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adverse effects*,
instrumentation Child Coronary Vessels / pathology Female Fibrosis Forensic Pathology Heart Atria / injuries*, pathology Humans Iliac Artery / injuries*, pathology Iliac Vein / injuries*, pathology Intra-Aortic Balloon Pumping Lung / pathology Pericardial Effusion / pathology Pulmonary Edema / pathology Takayasu Arteritis / pathology* Wounds, Penetrating / etiology, pathology* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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