Open AccessHOW CHALLENGING AN ELECTIVE SIMPLE CASE PROCEDURE CAN BE?
Author(s) -
Asen O. Ivanov,
Todor Gonovski,
H. Stoev
Publication year - 2019
Publication title -
knowledge
Language(s) - English
Resource type - Journals
eISSN - 2545-4439
pISSN - 1857-923X
DOI - 10.35120/kij3404981i
Subject(s) - medicine , cardiopulmonary bypass , extracorporeal circulation , extracorporeal membrane oxygenation , mechanical ventilation , extracorporeal , bypass grafting , artery , surgery , pulmonary edema , cardiology , complication , lung , anesthesia
The cardiopulmonary bypass, or heart-lung machine is one of the biggest medical inventions in the mid -20th century and the advances in cardiac surgery would not have been possible without this contrivance. Nevertheless it is not without its share of side-effects, with post-perfusion acute lung injury being among one of the most severe and life-threatening complications. We report a case of 65-year-old female patient diagnosed with left main and three-vessel coronary artery disease and admitted for an elective coronary artery bypass grafting(CABG). Triple bypass grafting procedure was performed. After weaning from bypass, the patient developed severe pulmonary edema with calculated Murray score of 4 points suggesting ECMO(extracorporeal membrane oxygenation) as the only salvage procedure. Peripheral venoarterial ECMO was implanted. After 5 days the mechanical support was withdrawn with full pulmonary recovery. Innovative cardiopulmonary bypass circuit and techniques, lung-protective mechanical ventilation strategies, ECMO etc. are amid possibilities to avoid this potentially lethal complication.