2008 年 41 巻 2 号 p. 44-48
We experienced a case of cardiac sudden death during a catheterization procedure. A male beagle dog was anesthetized with 1% halothane vaporized with 100% oxygen. A thermodilution catheter was positioned at the pulmonary artery through the right femoral vein, then a pig-tail catheter was positioned at the left ventricle through the right femoral artery. No significant changes were induced in the hemodynamic measurements during the procedure. However, when a quad-polar recording electrodes catheter was inserted to record His-bundle electrogram through the left femoral artery toward non-coronary cusp, the blood pressure was abruptly lowered to zero following a sense of resistance from the catheter. The catheter was immediately removed, while the dog fell in a cardiovascular collapse. Necrotomy was carried out immediately. A fossa was confirmed on the intima of arch of aorta, communicating with the dissection hematoma at the pulmonary artery via ligamentum arteriosum. These observations suggest that the electrode catheter was inserted into the fossa by chance, which might have partly re-opened the ductus arteriosus, leading to the onset of dissection hematoma of pulmonary artery and acute circulatory failure.