Cerebral arterial air embolism secondary to iatrogenic left atrial-esophageal fistula: a case report.

摘要: Cerebral arterial air embolism is a life-threatening complication that can result in neurologic deficits or death. Sometimes it iatrogenic, presented as of invasive medical procedures. Here we describe case cerebral secondary to iatrogenic left atrial-esophageal fistula, which the diagnosis might be covered up by complicated pathophysiologic changes. A 68-year-old man with unconsciousness hours after aphasia and right hemiplegia, accompanied hematemesis fever. He had history atrial fibrillation, treated radiofrequency catheter ablation 1 month ago. Brain CT displayed massive hemisphere, well parietal lobe. Chest demonstrated focus atrium, highly suggested an fistula. The patient received high flow (6 L/min) oxygen therapy. Intravenous antibiotics including imipenem vancomycin were administered together crystalloid rehydration. Supportive therapies given intubation, mechanical ventilation vasopressor use. Because patient’s unstable condition poor prognosis, surgical repair was considered but not pursued. very fast deterioration cardiac function circulatory failure, finally died from arrest. Clinicians must have index suspicion for fistula patients presenting chest discomfort, new onset stroke, upper gastrointestinal bleeding, development sepsis long 50 days fibrillation. Urgent ultimately establish most cases.