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

2014 ◽  
Vol 43 (4) ◽  
pp. 213-217 ◽  
Author(s):  
Naoki Kanemitsu ◽  
Kazuo Yamanaka ◽  
Takeshi Nishina ◽  
Keiichi Hirose ◽  
Akihiro Mizuno ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Pulmonary Edema ◽  
Mitral Valve Plasty ◽  
Right Thoracotomy

Echocardiographic and clinical outcome after mitral valve plasty with a minimal access or conventional sternotomy approach

2020 ◽  
Vol 61 (5) ◽  
Author(s):  
Lotte E. de Groot-de Laat ◽  
Kevin M. Veen ◽  
Jackie Mcghie ◽  
Frans B. Oei ◽  
Wouter J. van Leeuwen ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Clinical Outcome ◽  
Minimal Access ◽  
Mitral Valve Plasty

Abstract 15934: Refractory Cardiogenic Shock in a Patient With Hypertrophic Obstructive Cardiomyopathy and Mitral Regurgitation Necessitating Intra-Aortic Balloon Pump Use

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Indrajeet Mahata ◽  
Michael Faulx ◽  
Snigdha kola ◽  
Sweta Singh
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Cardiogenic Shock ◽  
Pulmonary Edema ◽  
Muscle Protein ◽  
Hypertrophic Obstructive Cardiomyopathy ◽  
Left Ventricular ◽  
Afterload Reduction ◽  
Intra Aortic Balloon Pump ◽  
Refractory Cardiogenic Shock

Introduction: Hypertrophic obstructive cardiomyopathy (HOCM) is a genetic disease due to a mutation in cardiac muscle protein resulting in left ventricular wall and septal hypertrophy. The presence of systolic anterior motion (SAM) of the mitral valve leads to dynamic left ventricular outflow tract (LVOT) obstruction. With increasing SAM of the anterior mitral leaflet there is resultant loss of coaptation leading to mitral regurgitation (MR). MR has been associated with HOCM but severe MR physiology causing refractory cardiogenic shock and requiring the use of afterload reduction through intra-aortic balloon pump (IABP) is rare and seems paradoxical to the conventional therapy for HOCM. Case summary: This is a case of 71year old female with HOCM, presenting with worsening shortness of breath. She had pulmonary vascular congestion on Chest X-ray and her Transthoracic Echocardiography demonstrated significant LVOT obstruction with moderate MR. She was being evaluated for myomectomy while being treated medically with beta blocker therapy for HOCM. She decompensated with acute respiratory failure from pulmonary edema, her blood pressure and oxygen saturation dropped. She was intubated. Swan- ganz catheter reading suggested wedge pressures of 22 and elevated pulmonary pressures. MvO2 was 32% and this was suggestive of cardiogenic shock. The Trans-esophageal echocardiogram (TEE) showed normal EF with severe concentric LVH and a moderate to severe (3+) MR due to restricted leaflet motion with regurgitant orifice area being 2.5cm2. At that point her MR was the dominant physiology behind her acute decompensation and cardiogenic shock and hence an IABP was placed for reducing afterload that helped in stabilizing her. Subsequently her wedge pressure and MvO2 improved, she was weaned off the IABP and extubated. The patient is being evaluated for myomectomy and mitral valve repair. Conclusion: This case illustrates complex hemodynamics and a challenging management due to competing MR and HOCM physiologies, too much central volume to offset HOCM may worsen MR and pulmonary edema while too much afterload reduction might worsen the HOCM. The use of IABP in a HOCM patient though seems paradoxical but was necessary in this setting to deal with complex physiologies.

Robotic Mitral Valve Surgery and Unilateral Pulmonary Edema

2020 ◽  
pp. 171-178
Author(s):  
Cindy Cheung ◽  
Christopher W. Tam
Keyword(s):  
Cardiopulmonary Bypass ◽  
Mitral Valve ◽  
Minimally Invasive ◽  
Pulmonary Edema ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Blood Product Transfusion ◽  
Unilateral Pulmonary Edema ◽  
Less Invasive Approach ◽  
The Difference

This chapter describes robotic or minimally invasive mitral valve surgery, which was pioneered in 1998 to be the less invasive approach to sternotomy-based mitral valve operations. Patients undergoing robotic valve surgery carry a similar risk of complications that may occur with traditional median sternotomy surgery, but minimally invasive valve surgery has its own inherent complications associated with cardiac access, perfusion, and ventilation methods used in robotic surgeries. Unilateral pulmonary edema (UPE) is an uncommon but potentially life-threatening complication of robotic mitral valve surgery. The incidence of unilateral lung injury, which commonly manifests as UPE, has been reported to be quite variable. The variation in incidence could be related to the difference in patient populations, diagnostic criteria, as well as management. Moreover, the pathophysiology of UPE associated with robotic mitral valve repair remains unclear. The current literature suggests that UPE can be prevented by shorter cardiopulmonary bypass times, avoiding barotrauma, limiting blood product transfusion, and minimizing lung isolation times. Lung preventive ventilation, such as low-level positive pressure and frequent alveolar recruitment, while on cardiopulmonary bypass may be beneficial. Meanwhile, treatment for UPE is dependent on the severity of symptoms.

scholarly journals Recurrent Pulmonary Edema in a Patient With a Prosthetic Mitral Valve

2009 ◽  
Vol 88 (3) ◽  
pp. 996-998
Author(s):  
Joris Schurmans ◽  
Bert Ferdinande ◽  
Siegmund Keuleers ◽  
Paul Herijgers ◽  
Werner Budts
Keyword(s):  
Mitral Valve ◽  
Pulmonary Edema ◽  
Prosthetic Mitral Valve

Right thoracotomy, femorofemoral bypass, and deep hypothermia for re-replacement of the mitral valve

1989 ◽  
Vol 48 (1) ◽  
pp. 69-71 ◽  
Author(s):  
Lawrence H. Cohn ◽  
Pamela S. Peigh ◽  
Jeffrey Sell ◽  
Verdi J. DiSesa
Keyword(s):  
Mitral Valve ◽  
Deep Hypothermia ◽  
Right Thoracotomy ◽  
Femorofemoral Bypass
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