Severe re‐expansion pulmonary edema after conventional cardiac surgery: Identification and management

Re‐expansion Pulmonary Edema (REPE) is a recognized but rare complication of lung re‐inflation after pathologic collapse or intentional deflation. The presentation of REPE may be highly variable, ranging from a clinically asymptomatic, incidental radiologic finding to acute respiratory failure accompanied by severe, life‐threatening hypoxemia. With the current report, we present a patient with severe aortic insufficiency, severe mitral regurgitation, coronary artery disease, pulmonary hypertension, who underwent aortic valve replacement, mitral valvuloplasty, coronary artery bypass grafting, and developed at the immediate post‐ operative period severe respiratory failure due to REPE, requiring venous‐venous Extracorporeal Membrane Oxygenation (VV‐ECMO).