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Liver laceration from a diaphragmatic suture in minithoracotomy mitral valve repair
Peter W Hashim1, Sabet W Hashim
1Section of Cardiac Surgery, Yale University School of Medicine, New Haven, Connecticut.
Abstract:
Mitral valve operations are increasingly performed through minimally invasive approaches such as the right anterior minithoracotomy. To facilitate exposure with this technique, a diaphragmatic suture may be implemented. We describe a liver laceration caused by the diaphragmatic suture in minithoracotomy mitral repair and its successful nonoperative management with arterial embolization.
Insights
Minimally invasive mitral valve repair using right anterior minithoracotomy can cause liver laceration from diaphragmatic sutures. This study details a successful nonoperative management of such injuries using arterial embolization.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Surgery
- Interventional Radiology
Background:
- Minimally invasive mitral valve operations, like right anterior minithoracotomy, are becoming standard.
- Diaphragmatic sutures are often used in these procedures to improve surgical exposure.
- Potential complications, such as iatrogenic injury, require careful consideration.
Observation:
- A liver laceration was identified as a complication.
- The injury was associated with the diaphragmatic suture used in mitral repair.
- This complication occurred during a right anterior minithoracotomy procedure.
Findings:
- The liver laceration was successfully managed without surgery.
- Arterial embolization was the chosen nonoperative treatment.
- The patient's condition was resolved through this interventional radiology technique.
Implications:
- Highlights a potential complication of diaphragmatic sutures in minimally invasive mitral surgery.
- Demonstrates the efficacy of arterial embolization for managing iatrogenic liver injuries.
- Provides a minimally invasive treatment option for a specific surgical complication.
