HLA
Successful Recovery from Possible Transfusion-Related Acute Lung Injury Following a Redo Aortic Valve Replacement

Shuhei Sakaguchi	Koji Furukawa	Eisaku Nakamura
Mitsuhiro Yano	Kunihide Nakamura

（Department of Cardiovascular Surgery, Miyazaki Medical Association Hospital, Miyazaki, Japan, and Cardiovascular, Thoracic and General Surgery, Miyazaki University Hospital＊, Miyazaki, Japan）

A 73-year-old man who underwent redo aortic valve replacement due to dysfunction of tissue heart valve developed hypoxemia with bilateral infiltrates on frontal chest radiograph and hypotension shortly after his operation. Due to the presence of progressive hypotension and hypoxemia, we inserted an intra-aortic balloon pump and, furthermore, provided percutaneous cardiopulmonary support. We ruled out cardiogenic pulmonary edema based on information from various examinations, including echocardiography, and subsequently diagnosed possible transfusion-related acute lung injury（possible TRALI). The patient was treated by mechanical ventilation and circulatory support under close supervision, showing a trend of improvement from postoperative day 2 and discontinuing mechanical ventilation on postoperative day 11. The patient made an uneventful recovery and was discharged on postoperative day 50. Cardiac surgery patients are at particular risk for TRALI, so physicians should consider TRALI whenever a patient develops hypoxemia during or shortly after transfusion. Rapid diagnosis and appropriate treatment of TRALI are especially important in cardiac surgery patients.

 

Jpn. J. Cardiovasc. Surg. 44:193-197（2015）

Keywords：transfusion-related acute lung injury;transfusion;cardiac surgery;hypoxemia;human leukocyte antigen