title: Multiple failed external defibrillation attempts during robot-assisted internal mammary harvest for myocardial revascularization.
abstract: We describe multiple failed external defibrillation attempts via rescue defibrillation pads for ventricular fibrillation that occurred secondary to direct electrical current transmission through the pericardial sac from electrocautery during robot-assisted internal mammary harvest. Only after resumption of two-lung ventilation and decompression of the iatrogenic pneumothorax was the patient successfully defibrillated. Conditions necessary for robotic intrathoracic surgery may make defibrillation and resuscitation difficult if they become necessary.
authors.affiliation: Department of Anesthesiology, University of Kentucky Chandler Medical Center, Lexington, Kentucky 40536, USA.
authors.forename: Kevin W
authors.initials: KW
authors.lastname: Hatton
authors.forename: Lawrence C
authors.initials: LC
authors.lastname: Kilinski
authors.forename: Chandrashekar
authors.initials: C
authors.lastname: Ramaiah
authors.forename: Randall M
authors.initials: RM
authors.lastname: Schell
mesh_terms: D000368:Aged; D047548:Defibrillators; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000502:physiology / Q000601:surgery*; D009204:Myocardial Revascularization / Q000295:instrumentation / Q000379:methods*; D012371:Robotics / Q000295:instrumentation / Q000379:methods*; D017211:Treatment Failure