Re-expansion pulmonary edema after minimally invasive cardiac surgery in children

Area of Science:

• Cardiology
• Thoracic Surgery
• Pediatric Surgery

Background:

• Minimally invasive cardiac surgery, particularly through a right mini-thoracotomy, is increasingly utilized.
• Re-expansion pulmonary edema (RPE) is a known, albeit serious, complication.
• The incidence and characteristics of RPE in pediatric cardiac surgery are not well-documented.

Observation:

• Two pediatric patients developed re-expansion pulmonary edema after atrial septal defect closure.
• The surgical approach was a minimally invasive right mini-thoracotomy.
• The cases involved simple atrial septal defect closure.

Findings:

• This is the first reported instance of re-expansion pulmonary edema following pediatric cardiac surgery.
• The complication occurred despite a seemingly straightforward surgical procedure.
• The findings highlight a potential risk associated with right mini-thoracotomy in pediatric cardiac procedures.

Implications:

• Clinicians should be vigilant for re-expansion pulmonary edema in pediatric patients undergoing cardiac surgery via right mini-thoracotomy.
• Further research is warranted to understand the pathophysiology and risk factors for RPE in this population.
• This case report may influence surgical approach selection and postoperative monitoring protocols in pediatric cardiac surgery.