Systemic air embolism during double sleeve left upper lobectomy: Caution regarding this fatal complication

DOI 11 References
  • Kawaguchi Koji
    Department of Thoracic Surgery, Nagoya University Graduate School of Medicine
  • Usami Noriyasu
    Department of Thoracic Surgery, Nagoya University Graduate School of Medicine
  • Taniguchi Tetsuo
    Department of Thoracic Surgery, Nagoya University Graduate School of Medicine
  • Ishikawa Yoshinori
    Department of Thoracic Surgery, Nagoya University Graduate School of Medicine
  • Fukui Takayuki
    Department of Thoracic Surgery, Nagoya University Graduate School of Medicine
  • Yokoi Kohei
    Department of Thoracic Surgery, Nagoya University Graduate School of Medicine

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  • 気管支・肺動脈管状切除を伴う左肺上葉切除の術中に発生した空気塞栓の1例：重篤合併症からの警鐘

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Abstract

We report a case of systemic air embolism that occurred during a double sleeve left upper lobectomy of the lung for cT2aN1M0 pulmonary adenocarcinoma. The patient was a 72-year-old male with severe emphysema. Immediately after an air leak test following bronchoplasty and pulmonary angioplasty, cardiac deterioration occurred. Transesophageal echocardiography revealed numerous microbubbles in his left atrium after resuscitation, and then we recognized massive air emboli. He could recover with cardio-pulmonary support and was discharged 2.5 months after the surgery. The cause of the air embolism was suspected to be systematic air entry at the peripheral lung induced during the air leak test under clamping of the pulmonary artery following bronchoplasty, and so we should be aware of the risk of such a fatal complication in patients with severe emphysema who undergo double sleeve resection.

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