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Mitral valve replacement in a patient with a collapsed lung
H Fujii1, S Suehiro, T Shibata
1Division of Cardiovascular Surgery, Second Department of Surgery, Osaka City University Medical School, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan.
The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai Zasshi
|March 22, 2001
Summary
This case study shows that cardiac surgery is safe for patients with only one functional lung, provided their respiratory function is adequate. Mitral valve replacement was successfully performed on a patient with severe mitral regurgitation and a history of pulmonary tuberculosis.
Area of Science:
- Cardiology
- Thoracic Surgery
- Pulmonology
Background:
- A 67-year-old male with a significant history of pulmonary tuberculosis presented with severe mitral regurgitation causing shortness of breath.
- Cardiac magnetic resonance imaging revealed significant cardiac displacement and rotation within the left thoracic cavity.
Observation:
- The patient exhibited reduced pulmonary function, with a forced expiratory volume per second of 46.7% and vital capacity of 72.1% of predicted values.
- Surgical intervention involved median sternotomy, extensive pericardial suspension to manage lung displacement, and extracorporeal circulation.
Findings:
- Mitral valve replacement with a mechanical prosthesis was successfully completed.
- The patient demonstrated a favorable recovery, being weaned from extracorporeal circulation and extubated on the same day as surgery.
Implications:
- This case highlights the feasibility of performing complex cardiac surgery in patients with compromised respiratory function, specifically those with a single functional lung.
- Adequate preoperative respiratory assessment is crucial for determining surgical candidacy and ensuring favorable outcomes in such challenging cases.