Bilateral Re-expansion Pulmonary Edema after Cardiac Surgery Successfully Treated with Venovenous Extracorporeal Membrane Oxygenation

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  • Kawatsu Satoshi
    Department of Cardiovascular Surgery, Iwate Prefectural Central Hospital
  • Otani Masayuki
    Department of Cardiovascular Surgery, Iwate Prefectural Central Hospital
  • Tabayashi Yuka
    Department of Cardiovascular Surgery, Iwate Prefectural Central Hospital
  • Ito Koki
    Department of Cardiovascular Surgery, Iwate Prefectural Central Hospital
  • Oda Katsuhiko
    Department of Cardiovascular Surgery, Iwate Prefectural Central Hospital

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  • 心臓手術後に発症した両側性再膨張性肺水腫に対し， Venovenous Extracorporeal Membrane Oxygenation で救命し得た1例

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Abstract

<p>A 57-year-old man was admitted with high fever and chest discomfort associated with aortic valve infective endocarditis. An echocardiogram showed severe aortic valve regurgitation. An emergent operation was performed. The aortic valve was destroyed and an annulus abscess was observed. Aortic valve replacement was performed. There was a large amount of pleural effusion in both chest cavities. Bilateral chest drainage was performed. Cardiopulmonary bypass weaning was performed uneventfully. The operation was finished without any mechanical support required. However, respiratory failure was observed to progress rapidly immediately after the operation. A postoperative X-ray showed bilateral pulmonary edema. Re-expansion pulmonary edema was diagnosed. Because oxygenation was not improved in ventilator settings, venovenous extracorporeal membrane oxygenation (V-V ECMO) was installed. Respiratory support with V-V ECMO was needed for 17 days postoperatively. It took 36 days before the patient was removed from the ventilator. V-V ECMO successfully managed bilateral re-expansion pulmonary edema.</p>

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