CO(2) embolism during minimally invasive vein harvesting.
CO(2) embolism is a known, though rare, complication of procedures using CO(2) insufflation. We report massive cardiac right atrial CO(2) embolism during minimally invasive harvesting of a varicose great saphenous vein. The patient's hemodynamics deteriorated significantly and needed to be stabilized by emergency institution of cardiopulmonary bypass. Causes of this rare but potentially lethal complication are discussed, as well as its prediction, diagnosis, and prevention.
Potapov
Evgenij V
EV
Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. potapov@dhzb.de
Buz
Semih
S
Hetzer
Roland
R
D000368:Aged; D000789:Angina, Unstable / Q000601:surgery; D002245:Carbon Dioxide; D001026:Coronary Artery Bypass / Q000009:adverse effects; D003324:Coronary Artery Disease / Q000601:surgery; D004618:Embolism, Air / Q000209:etiology*; D006801:Humans; D007327:Insufflation / Q000009:adverse effects; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects; D012501:Saphenous Vein / Q000601:surgery*; D020858:Tissue and Organ Harvesting / Q000009:adverse effects*; D014656:Vascular Surgical Procedures / Q000009:adverse effects
D002245:Carbon Dioxide