A case of the effective inhalation of nitric oxide therapy for caused severe pulmonary hypertension with protamine neutralization of systemic heparinization during totally endoscopic minimally invasive cardiac surgery
| Title: | A case of the effective inhalation of nitric oxide therapy for caused severe pulmonary hypertension with protamine neutralization of systemic heparinization during totally endoscopic minimally invasive cardiac surgery |
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| Authors: | Takeichi Tomohisa, Morimoto Yoshihisa, Yamada Akitoshi, Tanaka Takanori |
| Source: | The Journal of ExtraCorporeal Technology, Vol 56, Iss 3, Pp 120-124 (2024) |
| Publisher Information: | EDP Sciences, 2024. |
| Publication Year: | 2024 |
| Collection: | LCC:Medicine |
| Subject Terms: | cardiopulmonary bypass (cpb), nitric oxide, respiratory therapy, pulmonary hypertension, protamine, Medicine |
| More Details: | Severe pulmonary vasoconstriction induced by protamine is a rare complication. We report a case of a 77-year-old male patient with a history of mitral valve plasty (MVP). He underwent redo MVP via right thoracotomy under the totally endoscopic procedure (MICS redo-MVP). Immediately after weaning cardiopulmonary bypass (CPB), protamine was administrated. 10 min later peak systolic pulmonary arterial pressure (sys PAP) rose to 62 mmHg, and 30 min later to 80 mmHg. Due to the negative impact of protamine administration, nitric oxide inhalation (iNO) therapy was started with a concentration of 20 ppm. 10 min after iNO therapy started, sys PAP decreased to 63 mmHg. After entering the intensive care unit (ICU), sys PAP decreased to 35 mmHg. Here, we present an effective iNO therapy case for pulmonary hypertension due to protamine and the patient had a good postoperative recovery. This study was approved by the Institutional Review Board at Kitaharima Medical Center (IRB-0602) with the waiver of informed consent. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English |
| ISSN: | 0022-1058 2969-8960 |
| Relation: | https://ject.edpsciences.org/articles/ject/full_html/2024/03/ject240016/ject240016.html; https://doaj.org/toc/0022-1058; https://doaj.org/toc/2969-8960 |
| DOI: | 10.1051/ject/2024018 |
| Access URL: | https://doaj.org/article/131624ef545b406895afbd3b000854df |
| Accession Number: | edsdoj.131624ef545b406895afbd3b000854df |
| Database: | Directory of Open Access Journals |
| ISSN: | 00221058 29698960 |
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| DOI: | 10.1051/ject/2024018 |
| Published in: | The Journal of ExtraCorporeal Technology |
| Language: | English |