Two Cases of Reexpansion Pulmonary Edema after Cardiac Surgery

Tomomitsu Kanaya	Hiroki Hata and Nobuo Sakagoshi

（Department of Cardiovascular Surgery, Kinan Hospital, Tanabe, Japan）

A 54-year-old man with ischemic mitral regurgitation underwent surgical ventricular restoration, mitral valve plasty and a coronary artery bypass. A chest X-ray 7 days later revealed pleural effusion on the right side. A chest tube was inserted and about 1,000ml of fluid was drained. However, re-expansion pulmonary edema（RPE）occurred 2h later. Positive pressure ventilation and intravenous infusion with a diuretic improved the RPE. He was resuscitated on the following day to receive percutaneous cardiopulmonary support（PCPS）for unstable hypoxemia and hypotension. Oxygenation improved, PCPS was withdrawn 2 days later, and the endotracheal tube was removed. Re-expansion pulmonard. He was resuscitated on the following day to receive percutaneous cardiopulmonary support（PCPS）for unstable hypoxemia and hypotension. Oxygenation improved, PCPS was withdrawn 2 days later, and the endotracheal tube was removed. Re-expansion pulmonary edema might cause fatal short-term cardio-respiratory failure. We considered that RPE requires appropriate early diagnosis, early treatment and aggressive therapy, including PCPS.

　

Jpn. J. Cardiovasc. Surg. 43:138-141（2014）

Keywords：cardiac surgery;reexpansion pulmonary edema;PCPS