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Visual laryngeal mask for intraoperative ventilation in mitral valve surgery with tuberculous destroyed lung: a case report

Year: 2026

Type: article

Abstract: Tuberculous destroyed lung (TDL) is a severe irreversible sequela of chronic pulmonary tuberculosis, characterized by extensive parenchymal destruction, fibrosis and volume loss, which leads to significant ventilatory dysfunction. Combined with rheumatic mitral valve disease (RMVD), such patients face extremely high challenges in intraoperative respiratory management and surgical safety. Herein, we report a case of a 56-year-old female with left TDL complicated with severe mitral regurgitation and moderate mitral stenosis who underwent biological mitral valve replacement, tricuspid annuloplasty, left atrial appendage amputation and pulmonary vein isolation under cardiopulmonary bypass, with the surgical procedure consistent with the medical record. A visual laryngeal mask was innovatively adopted for intraoperative respiratory maintenance instead of traditional endotracheal intubation, and the visual laryngeal mask was extubated immediately after the operation, which effectively ensured stable oxygenation and ventilation throughout the operation despite the patient’s unilateral effective pulmonary ventilation. Postoperatively, the patient developed mild right pleural effusion, which was relieved by thoracentesis, and no severe respiratory complications such as hypoxemia or acute respiratory distress syndrome occurred. The patient was discharged stably after 26 days of hospitalization, and the 3-month follow-up showed good recovery of cardiac and respiratory function. This case highlights the clinical value of visual laryngeal mask in intraoperative respiratory management for patients with TDL complicated with cardiac valve disease, and emphasizes the importance of multidisciplinary team (MDT) collaboration and fast-track anesthesia in preoperative evaluation, surgical planning, intraoperative management and postoperative complication control for such high-risk patients.

Source: BMC Anesthesiology

DOI: 10.1186/s12871-026-04336-3