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Paradoxical Air Embolism Without Patent Foramen Ovale During Craniotomy in the Sitting Position

Craniotomy in the sitting position entails risk for venous air embolism (VAE). A 50-year-old male underwent pineal region mass resection through a sitting position craniotomy. Intraoperative transesophageal echocardiography confirmed the absence of intracardiac shunt. During craniotomy, VAE was note...

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Autores principales: Maragkos, Georgios A, Davanzo, Justin, Roberts, S M, Zacharia, Brad E
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6550496/
https://www.ncbi.nlm.nih.gov/pubmed/31192060
http://dx.doi.org/10.7759/cureus.4355
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author Maragkos, Georgios A
Davanzo, Justin
Roberts, S M
Zacharia, Brad E
author_facet Maragkos, Georgios A
Davanzo, Justin
Roberts, S M
Zacharia, Brad E
author_sort Maragkos, Georgios A
collection PubMed
description Craniotomy in the sitting position entails risk for venous air embolism (VAE). A 50-year-old male underwent pineal region mass resection through a sitting position craniotomy. Intraoperative transesophageal echocardiography confirmed the absence of intracardiac shunt. During craniotomy, VAE was noted inside the patient’s right heart, leading to hemodynamic instability. After repositioning to the supine position, significant crossover of air into the left heart was noted. Postoperatively, multiple small embolic strokes were noted. Patients who undergo craniotomy in the sitting position and are not found to have a patent foramen ovale (PFO) are not free of risk for paradoxical air embolism (PAE).
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spelling pubmed-65504962019-06-12 Paradoxical Air Embolism Without Patent Foramen Ovale During Craniotomy in the Sitting Position Maragkos, Georgios A Davanzo, Justin Roberts, S M Zacharia, Brad E Cureus Neurosurgery Craniotomy in the sitting position entails risk for venous air embolism (VAE). A 50-year-old male underwent pineal region mass resection through a sitting position craniotomy. Intraoperative transesophageal echocardiography confirmed the absence of intracardiac shunt. During craniotomy, VAE was noted inside the patient’s right heart, leading to hemodynamic instability. After repositioning to the supine position, significant crossover of air into the left heart was noted. Postoperatively, multiple small embolic strokes were noted. Patients who undergo craniotomy in the sitting position and are not found to have a patent foramen ovale (PFO) are not free of risk for paradoxical air embolism (PAE). Cureus 2019-04-01 /pmc/articles/PMC6550496/ /pubmed/31192060 http://dx.doi.org/10.7759/cureus.4355 Text en Copyright © 2019, Maragkos et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Neurosurgery
Maragkos, Georgios A
Davanzo, Justin
Roberts, S M
Zacharia, Brad E
Paradoxical Air Embolism Without Patent Foramen Ovale During Craniotomy in the Sitting Position
title Paradoxical Air Embolism Without Patent Foramen Ovale During Craniotomy in the Sitting Position
title_full Paradoxical Air Embolism Without Patent Foramen Ovale During Craniotomy in the Sitting Position
title_fullStr Paradoxical Air Embolism Without Patent Foramen Ovale During Craniotomy in the Sitting Position
title_full_unstemmed Paradoxical Air Embolism Without Patent Foramen Ovale During Craniotomy in the Sitting Position
title_short Paradoxical Air Embolism Without Patent Foramen Ovale During Craniotomy in the Sitting Position
title_sort paradoxical air embolism without patent foramen ovale during craniotomy in the sitting position
topic Neurosurgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6550496/
https://www.ncbi.nlm.nih.gov/pubmed/31192060
http://dx.doi.org/10.7759/cureus.4355
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