Unilateral Postoperative Pulmonary Edema After Minimally Invasive Cardiac Surgical Procedures: A Case-Control Study

Tutschka, M.; Bainbridge, Daniel; Chu, Michael; Kiaii, Bob; Jones, Philip M.

doi:10.1016/j.athoracsur.2014.07.067

Cited by 43 publications

(43 citation statements)

References 13 publications

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“…In the literature, all data about unilateral lung edema come from the studies that included patients undergoing cardiac surgery with lung isolation using DL tubes or bronchial blockers 15‐19,25,26 . In our series, no patient developed unilateral lung edema in the SL group.…”

Section: Commentsmentioning

confidence: 62%

“…Currently, DL endotracheal intubation with lung isolation is the standard for robotic cardiac surgery in high volume robotic cardiac centers 1‐3,10,11,15‐19 . This approach has been applied in video‐assisted cardiothoracic surgery to ensure lung exclusion 20‐26 . However, proper placement of DL endotracheal tubes or bronchial blockers for lung isolation is a complex procedure, requires experienced anesthesiologists and carries potential hazards even in experienced hands 12‐15 .…”

Section: Commentsmentioning

confidence: 99%

“…Despite the presence of a limited number of patients having pulmonary edema, statistical analysis showed no association of pulmonary edema with CPB time, total anesthesia time, DL intubation, multiple intubation attempts, and difficult intubation. Tutschka et al 26 noted that longer CPB, preexisting obstructive lung disease and preexisting pulmonary hypertension or significant right ventricular dysfunction independently increased the risk of unilateral postoperative pulmonary edema. However, we reported a shorter CPB time in patients with SL tube and some authors think this can be impossible.…”

Section: Commentsmentioning

confidence: 99%

“…Nevertheless, right‐sided unilateral pulmonary edema developed in several patients. With the goal of providing better outcomes, the studies and alternative techniques in minimally invasive cardiac surgery were reviewed 1‐26 . The literature on robotic cardiac surgery presented no recommendations about the use of SL endotracheal tubes without lung isolation.…”

Section: Introductionmentioning

confidence: 99%

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Robotic‐assisted cardiac surgery without lung isolation utilizing single‐lumen endotracheal tube intubation

et al. 2020

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Objectives This study assessed the feasibility and outcomes of performing robotic cardiac surgery without lung isolation using single‐lumen (SL) endotracheal tube intubation. Methods Between 2013 and 2017, 132 patients underwent robotically‐assisted atrial septal defect closure. A retrospective analysis was performed of 23 patients (11 males, mean age 30.9 ± 5 years) who underwent robotic surgery with double‐lumen (DL) endotracheal tube intubation (group 1) compared with 109 patients (57 males, mean age 32.4 ± 7.5 years) undergoing the same procedure with SL endotracheal intubation (group 2). The patient groups were compared in terms of demographic characteristics, operative data, and complications. The technical feasibility of the robotic procedure without lung isolation was evaluated. Results There were no mortality, intraoperative complication, and conversion. Mean total anesthesia time was significantly decreased in the SL intubation group (238.3 ± 22.4 vs 227.2 ± 21.2 minutes; P = .025). First‐pass intubation success was significantly higher in the SL intubation group (17 [73.9%] vs 98 [89.9%] patients; P = .032). Mean ventilation time (10.9 ± 5.3 hours), intensive care unit stay (16.8 ± 10.1 hours), and the length of hospital stay (3.8 ± 1.2 days) was significantly decreased in patients with SL tube (P < .05). Unilateral reexpansion pulmonary edema was observed in five (21.7%) patients with DL tube, whereas no patient with SL tube had this complication. Conclusions SL endotracheal tube intubation without lung isolation is a feasible and safe airway alternative in robotic cardiac procedures. This approach resulted in shorter anesthesia time, ventilation time and the length of hospital stay. Port placement and robotic set‐up can be uneventfully performed without lung isolation.

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Section: Commentsmentioning

confidence: 62%

Section: Commentsmentioning

confidence: 99%

Section: Commentsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Robotic‐assisted cardiac surgery without lung isolation utilizing single‐lumen endotracheal tube intubation

et al. 2020

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“…2,14) However, it can be infrequently observed after open heart surgery with a short period of one-lung ventilation. In our experience, RPE occurred 1 day after surgery in case 1 even if the duration of operation (360 min) and CPB (183 min) were relatively short (Fig.…”

Section: Discussionmentioning

confidence: 99%