Unilateral Pulmonary Edema After Robotically Assisted Mitral Valve Repair Requiring Veno-Venous Extracorporeal Membrane Oxygenation

Dan Viox; Richa Dhawan; Husam H Balkhy; Daniel Cormican; Himani Bhatt; Andre Savadjian; Mark A Chaney

doi:10.1053/j.jvca.2021.03.051

Unilateral Pulmonary Edema After Robotically Assisted Mitral Valve Repair Requiring Veno-Venous Extracorporeal Membrane Oxygenation

J Cardiothorac Vasc Anesth. 2022 Jan;36(1):321-331. doi: 10.1053/j.jvca.2021.03.051. Epub 2021 Apr 5.

Authors

Dan Viox¹, Richa Dhawan², Husam H Balkhy³, Daniel Cormican⁴, Himani Bhatt⁵, Andre Savadjian⁶, Mark A Chaney⁷

Affiliations

¹ Department of Anesthesiology, Emory University Hospital, Atlanta, GA.
² Department of Anesthesia and Critical Care, University of Chicago, Chicago, IL.
³ Robotic and Minimally Invasive Cardiac Surgery, University of Chicago Medicine and Biological Sciences, Chicago, IL.
⁴ Cardiothoracic Anesthesiology, Allegheny General Hospital, Surgical Critical Care Medicine, Western Pennsylvania Hospital, Allegheny Health Network, Pittsburgh, PA.
⁵ Division of Cardiac Anesthesiology, Mount Sinai Morningside Medical Center, New York, NY; Icahn School of Medicine at Mount Sinai, New York, NY.
⁶ Division of Cardiac Anesthesiology, Mount Sinai Morningside Medical Center, New York, NY.
⁷ Department of Anesthesia and Critical Care, University of Chicago, Chicago, IL. Electronic address: mchaney@dacc.uchicago.edu.

PMID: 33975792
DOI: 10.1053/j.jvca.2021.03.051

Abstract

Unilateral pulmonary edema (UPE) is an uncommon yet potentially life-threatening complication of minimally invasive cardiac surgery (MICS). Most frequently described after robotically assisted mitral valve (MV) repair, it is characterized by right lung edema, hypoxemia, hypercapnia, pulmonary hypertension, and hemodynamic instability beginning minutes-to-hours after separation from cardiopulmonary bypass (CPB). The authors describe a severe case with refractory hypoxemia requiring veno-venous (VV) extracorporeal membrane oxygenation (ECMO) after robotically assisted MV repair.

Keywords: membrane oxygenation; mitral valve repair; pulmonary edema.

MeSH terms

Cardiac Surgical Procedures* / adverse effects
Extracorporeal Membrane Oxygenation* / adverse effects
Humans
Mitral Valve / diagnostic imaging
Mitral Valve / surgery
Pulmonary Edema* / diagnostic imaging
Pulmonary Edema* / etiology
Robotic Surgical Procedures* / adverse effects