Re-expansion Pulmonary Edema after Mitral Valve Plasty via Small Right Thoracotomy

Naoki Kanemitsu	Kazuo Yamanaka	Takeshi Nishina
Keiichi Hirose	Akihiro Mizuno	Daisuke Nakatsuka
Yuki Hori	Daisuke Yasumizu and Masashi Yada

（Department of Cardiovascular Surgery, Tenri Hospital, Tenri, Japan）

We report a case of re-expansion pulmonary edema（REPE), which complicated mitral valve plasy via right small thoracotomy. A 56-years old man underwent mitral valve plasty for severe mitral regurgitation caused by P2 prolapse. After separation from heart-lung machine, massive yellow foamy secretion has begun to spout from the right side endotracheal tube and hypoxemia has ensued. Differential ventilation with high airway pressure and steroid pulse therapy could not counteract the exacerbation of hypoxemia. Echocardiography showed severe diffuse hypokinesis of left ventricular wall. Intra-aortic balloon pumping and percutaneous cardiopulmonary support（PCPS）were introduced, and they were very effective. After five-days’ support, PCPS was successfully weaned. The patient recovered well. REPE complicated by mini-thoracotomy approach cardiac surgery, is rare, but can be fatal.

 

Jpn. J. Cardiovasc. Surg. 43:213-217（2014）

Keywords：minimally invasive cardiac surgery;re-expansion pulmonary edema;percutaneous cardiopulmonary support