Abstract:
Well-known complication associated with patent foramen ovale (PFO) closure include infection, acute cardiac tamponade, and local complications such as adjacent arterial or nerve damage, hemorrhage, and thrombophlebitis. Pelvic hematoma is rare and potentially fatal complication. This paper reports two cases of severe hemorrhagic shock within1 day after PFO closure. Both female patients presented to our department with history of headaches and were diagnosed with PFO. Both patients underwent percutaneous PFO closure from the right femoral vein. One day after the procedure, both patients experienced pelvic hematoma and were successfully rescued by compression hemostasis and uterine artery embolization. Both patients recovered well during follow-up. Life-threatening pelvic hematoma associated with PFO closure has a certain incidence and should be considered. Peripheral vascular complications after PFO closure can be safely treated but should not be ignored. We believe that the prevention of vascular mechanical damage during surgery is important. The possibility of spontaneous uterine artery rupture should be considered for unexplained pelvic hematoma. Although it is a rare complication, severe bleeding after PFO closure remains unpredictable. Timely and correct diagnosis and appropriate treatment are required. If the timing is delayed, there could be serious consequences.
摘要:
与卵圆孔未闭(PFO)闭合相关的众所周知的并发症包括感染,急性心包填塞,以及邻近动脉或神经损伤等局部并发症,出血,和血栓性静脉炎.盆腔血肿是罕见且潜在致命的并发症。本文报告2例PFO封堵后1天内发生严重失血性休克。两名女性患者均有头痛史,并被诊断为PFO。两名患者均从右股静脉经皮PFO闭合。手术后的一天,两名患者均出现盆腔血肿,并通过压迫止血和子宫动脉栓塞术成功抢救。两名患者在随访期间恢复良好。与PFO闭合相关的危及生命的盆腔血肿具有一定的发生率,应予以考虑。PFO封堵术后外周血管并发症可以安全治疗,但不容忽视。我们认为,在手术过程中预防血管机械损伤很重要。对于原因不明的盆腔血肿,应考虑自发性子宫动脉破裂的可能性。虽然这是一种罕见的并发症,PFO封堵后严重出血仍不可预测.需要及时正确的诊断和适当的治疗。如果时间延迟,可能会有严重的后果。