Carbon dioxide embolism during minimally invasive vein harvesting.
Gas embolism is a known complication of minimal access procedures in which carbon dioxide insufflation is used. We report a case of significant venous and right heart gas embolization, which occurred during performance of routine minimally invasive vein harvesting. This was manifest by hemodynamic deterioration secondary to transmission by a patent foramen ovale into the left heart and coronary circulation. Techniques to predict, diagnose, and prevent this rare but potentially fatal complication of minimally invasive vein harvesting are suggested.
Banks
Thomas A
TA
Long Island Jewish Medical Center, North Shore-LIJ Health System, New Hyde Park, New York 11040, USA.
Manetta
Frank
F
Glick
Mark
M
Graver
L Michael
LM
D000368:Aged; D002245:Carbon Dioxide; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000150:complications / Q000601:surgery; D004618:Embolism, Air / Q000209:etiology* / Q000628:therapy; D004724:Endoscopy / Q000009:adverse effects*; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000601:surgery; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000601:surgery; D012501:Saphenous Vein / Q000601:surgery* / Q000637:transplantation; D013048:Specimen Handling / Q000009:adverse effects*
D002245:Carbon Dioxide