Two Cases of Reexpansion Pulmonary Edema after Cardiac Surgery / 日本心臓血管外科学会雑誌

ABSTRACT

A 54-year-old man with ischemic mitral regurgitation underwent surgical ventricular restoration, mitral valve plasty and a coronary artery bypass. A chest X-ray 7 days later revealed pleural effusion on the right side. A chest tube was inserted and about 1,000 ml of fluid was drained. However, re-expansion pulmonary edema (RPE) occurred 2 h later. Positive pressure ventilation and intravenous infusion with a diuretic improved the RPE. He was resuscitated on the following day to receive percutaneous cardiopulmonary support (PCPS) for unstable hypoxemia and hypotension. Oxygenation improved, PCPS was withdrawn 2 days later, and the endotracheal tube was removed. Re-expansion pulmonard. He was resuscitated on the following day to receive percutaneous cardiopulmonary support (PCPS) for unstable hypoxemia and hypotension. Oxygenation improved, PCPS was withdrawn 2 days later, and the endotracheal tube was removed. Re-expansion pulmonary edema might cause fatal short-term cardio-respiratory failure. We considered that RPE requires appropriate early diagnosis, early treatment and aggressive therapy, including PCPS.