par Fagnoul, David 
;Herpain, Antoine ;Vincent, Jean Louis ;De Backer, Daniel
Référence Revista brasileira de terapia intensiva, 25, 4, page (345-347)
Publication Publié, 2013
;Herpain, Antoine ;Vincent, Jean Louis ;De Backer, Daniel Référence Revista brasileira de terapia intensiva, 25, 4, page (345-347)
Publication Publié, 2013
Article révisé par les pairs
| Résumé : | We describe the case of a patient with an intramural hematoma and foating thrombus after cardiopulmonary resuscitation. The 92-year old man had a cardiac arrest due to ventricular fibrillation and witnesses immediately initiated manual cardiopulmonary resuscitation. Transesophageal echocardiography was performed immediately on hospital admission because the patient was in cardiogenic shock. In addition to an akinetic anterior wall, examination of the descending thoracic aorta demonstrated an intramural hematoma and a floating intra-aortic thrombus at a distance of 40cm from the dental arch. There was no aortic dissection. The thrombus was attributed to aortic compression during cardiopulmonary resuscitation. Although the aortic thrombus and intramural hematoma were not associated with any complications in this patient, insertion of an intra-aortic balloon may have led to aortic rupture or embolic events. Transesophageal echocardiography should be performed, when available, prior to insertion of an intra-aortic balloon for counterpulsation in patients who have undergone cardiopulmonary resuscitation. |
