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Case report
A silent compartment syndrome following elective minimally invasive mitral valve repair
  1. Charles Godavitarne1,
  2. Joideep Phadnis2 and
  3. Ishtiaq Ahmed2
  1. 1 Department of Trauma and Orthopaedics, NHS, Tunbridge Wells Hospital, UK
  2. 2 Department of Trauma and Orthopaedics, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
  1. Correspondence to Dr Charles Godavitarne, charles.godavitarne{at}nhs.net

Abstract

A 63-year-old male with severe mitral valve regurgitation underwent an elective minimally invasive mitral valve repair. Peripheral cannulation of the right femoral vein and artery was performed with a total cardiopulmonary bypass time of 268 min. There were no intraoperative complications. 12 hours postoperatively the patient reported mild pain in the right lower leg with a subjective decrease in sensation. Compartmental pressures were significantly raised. The patient underwent lower leg fasciotomies, which revealed bulging compartments confirming the diagnosis of an evolving compartment syndrome (CS). This rare case demonstrates the highly variable aetiology, pathophysiology and presenting symptoms of CS. Clinicians in any specialty should consider this diagnosis if there is a possibility of local vascular compromise secondary to an intervention/treatment. This diagnosis is not exclusive to patients with trauma and as such clinicians should have a high index of suspicion for this potentially devastating condition.

  • musculoskeletal and joint disorders
  • cardiothoracic surgery
  • orthopaedic and trauma surgery
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Footnotes

  • Contributors CG: clinician directly involved in review of the patient and workup to surgery. Responsible for decision to proceed to case report, write-up and structure of the article, data acquisition and final proofing. JP: consultant directly involved in the case from presentation to surgery. Assisted in article structure and write up. Critically appraised the article and provided feedback on how to restructure when required. IA: consultant who performed the initial elective procedure. Involved in supplying information relevant to the procedure as well as critical appraisal of the Cardiothoracic aspects of the case. Involved in critical appraisal and final proofing. All authors were actively involved in drafting and critical appraisal of the final article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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