Unilateral pulmonary oedema after minimally invasive cardiac surgery via right anterolateral minithoracotomy

Abstract

Our data revealed a 7.9% incidence of radiographically evident unilateral pulmonary oedema after MICS with intraoperative collapse of a lung. Of the total number of patients, 1.5% simultaneously developed clinical symptoms. The influence of corticosteroids, as well as the contribution of possible risk factors, needs further evaluation.

The Opportunities and Limitations of Minimally Invasive Cardiac Surgery

“…Furthermore, reports exist of mostly unilateral pulmonary edema after access through right-sided minithoracotomy. Keyl et al described-in a study of 485 patients treated by using minimally invasive surgery-a rate of 7.85% (28). The causes of pulmonary edema, which in practice has been described only for minimally invasive valve surgery, are not known.…”

“…What is striking, however, is that all publications on this subject used one-lung ventilation through a double-lumen endotracheal tube. The studies described the following risk factors: • Pulmonary hypertension • Administration of fresh frozen plasma (28)(29)(30).…”

Radiological Incidence of Unilateral Pulmonary Edema After Minimally Invasive Cardiac Surgery

“…One study using DLV found a 7.9% incidence of UPE on CXR after MICs (defined as large-scale, ground-glass opacities), which was clinically relevant in 1.5% of patients, with prolonged postoperative ventilation up to 306.5 hours. 5 In studies using OLV for MICs, the incidence of postoperative UPE varied between 2.1% and 25%. 6À8 The considerable difference between studies probably is due to the different assessment criteria.…”

Prevention of Pulmonary Edema after Minimally Invasive Cardiac Surgery with Mini-Thoracotomy Using Neutrophil Elastase Inhibitor

“…7,9) Recently, Keyl et al 8) described that 7.9% incidence of radiographically evident RPE after MICS. They reported that among total number of MICS patients, 1.5% developed clinical symptoms.…”

“…Although mechanical stress and histologic abnormalities of the pulmonary microcirculation were reported as mechanisms of RPE, the risk factors after cardiac surgery with single-lung ventilation are still unknown. 8,15,16) It is well known that CPB induces a systemic inflammatory response called post-pump syndrome. Although some organs can be involved, the lung is often the first organ damaged, making this a major complication of CPB.…”