A case of right ventricular failure due to air embolism after robotic mitral valve plasty

Abstract

　A 42-year-old woman with severe mitral regurgitation (MR) was scheduled for robotic mitral valve plasty. She developed right ventricular failure after surgery due to air embolism in the right coronary artery. Maximal values of CKMB at this time were 130 U/l, and right ventricular wall motion on transthoracic echocardiography (TTE) had fully recovered with no local asynergy about 10 days after surgery. Finally, electrocardiography showed poor progression of the R wave in leads II, III, and AVF, but with no abnormal Q wave or negative T wave.

　We speculate that our patient's clinical features were secondary to the air embolism causing a small subendocardial infarction with myocardial stunning. De-airing following robot-assisted surgery is difficult since the patient's position cannot be changed due to the robotic arm being inserted into the patient's thoracic cavity.