Postoperative visual loss due to complicated mediastinal dissection and haemorrhagic shock treatment during cardiac surgery.
We report the case of a patient who underwent third time revision of double heart valve replacement. Mediastinal dissection for right atrium cannulation was complicated by laceration of the superior vena cava; this required temporary rescue clamping of the vessel. The patient suffered complete visual loss related to bilateral retrobulbar haematoma. Acute elevation of superior vena cava pressure due to vascular clamping and administration of large amounts of fluid through the central venous jugular catheter could have caused the postoperative visual loss.
Faculté de Médecine, Université Paris Est, 8 avenue du Général Sarrail, Créteil 94000, France.
N
N
Mongardon
S
S
Zraier
H
H
Haouache
W
W
Kamoun
V
V
Slavov
M
M
Dababi
J-P
JP
Couetil
G
G
Dhonneur
D001766:Blindness / Q000209:etiology*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D003250:Constriction; D005260:Female; D005440:Fluid Therapy / Q000379:methods; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects; D006406:Hematoma / Q000150:complications*; D006801:Humans; D007022:Hypotension / Q000150:complications*; D008482:Mediastinum / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D012086:Reoperation; D019315:Retrobulbar Hemorrhage / Q000150:complications; D012771:Shock, Hemorrhagic / Q000150:complications; D014057:Tomography, X-Ray Computed / Q000379:methods; D014683:Vena Cava, Superior / Q000293:injuries
complications, neurological; shock, haemorrhagic; surgery, cardiac