What Happened During the Insertion of a Superior Vena Cava Cannula and Pulmonary Artery Catheter for Minimally Invasive Robot-Assisted Cardiac Surgery?

摘要

A 59-year-old woman weighing 52.5 kg and 158.7 cm tall was admitted with a diagnosis of mitral regurgitation and atrial fibrillation. A routine laboratory examination produced no significant preoperative findings except for severe rheumatic mitral regurgitation, mild mitral stenosis, and atrial fibrillation. Surgery was scheduled for mitral valvuloplasty and the Maze operation using a robotically controlled camera (AESOP3000; Computer Motion, Santa Barbara, CA) for minimally invasive robot-assisted thoracotomy, with a preoperative plan to perform single-lung ventilation, continuous monitoring of mixed venous saturation and cardiac output with the pulmonary artery (PA) catheter, and insertion of a superior vena cava (SVC) cannula via the right internal jugular vein. No medication was administered on the day of surgery. Blood pressure, cardiac rhythm, and oxygen saturation were monitored in the operating room. Anesthesia was induced with intravenous midazolam(0.2 mg/kg), sufentanil (1 mug/kg), and vecuronium (0.15 mg/kg). The trachea was intubated using a 35F left double-lumen tube (Broncho-cath; Mallinckrodt, Dublin, Ireland).