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机器人辅助二尖瓣修复术后单侧肺水肿需行静脉-静脉体外膜肺氧合治疗

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

机构信息

Department of Anesthesiology, Emory University Hospital, Atlanta, GA.

Department of Anesthesia and Critical Care, University of Chicago, Chicago, IL.

出版信息

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

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.

摘要

单侧性肺水肿(UPE)是微创心脏手术(MICS)的一种罕见但潜在致命的并发症。最常发生在机器人辅助二尖瓣(MV)修复后,其特征是右肺水肿、低氧血症、高碳酸血症、肺动脉高压和血流动力学不稳定,发生在从体外循环(CPB)分离后数分钟至数小时内。作者描述了一例机器人辅助 MV 修复后发生难治性低氧血症需要静脉-静脉(VV)体外膜氧合(ECMO)的严重病例。

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