Transesophageal echocardiography detected a 1-cm liver laceration during minimally invasive cardiac surgery, allowing for immediate surgical intervention and recovery without complications.
Routine deep transgastric TEE sweeps during minimally invasive cardiac surgery can rapidly identify life-threatening iatrogenic intra-abdominal injuries, enabling immediate intervention.
Absolute Event Rate: 0% vs 0%
Minimally invasive cardiac surgery (MICS) reduces surgical trauma but limits direct visualization of surrounding structures, posing a risk of unrecognized injury. A 65-year-old man with alcoholic cirrhosis underwent mitral valvuloplasty, tricuspid annuloplasty, and Maze procedure via right mini-thoracotomy. During cardiopulmonary bypass (CPB), progressive reservoir volume loss was noted by a perfusionist. However, no collection of blood was evident in the surgical field, and thus, reservoir volume was maintained with volume transfusion. After weaning from CPB, transesophageal echocardiography (TEE) revealed free fluid around the liver. Exploratory laparoscopy confirmed a 1-cm liver laceration likely caused during a trocar insertion. Hemostasis was achieved surgically, and the patient recovered without complications. Iatrogenic liver injury during MICS is rare and may lack intraoperative hemodynamic signs. In this case, timely intraoperative detection of abdominal bleeding using TEE enabled immediate intervention. Routine TEE assessment of intra-abdominal free fluid may help identify similar injuries early and improve patient outcomes.
Yanagi et al. (Tue,) reported a other. Transesophageal echocardiography detected a 1-cm liver laceration during minimally invasive cardiac surgery, allowing for immediate surgical intervention and recovery without complications.
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