Visual laryngeal mask supports ventilation in mitral valve surgery with destroyed lung

A 56-year-old woman with a severely damaged lung caused by tuberculosis has undergone successful mitral valve surgery in which anesthesiologists replaced the conventional breathing tube with a visual laryngeal mask airway, according to a case report published in BMC Anesthesiology on 26 October 2026.

The patient suffered from tuberculous destroyed lung, a severe and irreversible consequence of chronic pulmonary tuberculosis. The condition is characterized by extensive destruction of lung tissue, fibrosis, and loss of lung volume, all of which lead to significant ventilatory dysfunction. In her case, the left lung was affected, and she also had severe mitral regurgitation together with moderate mitral stenosis, a combination that made both the operation and the anesthesia around it exceptionally risky.

Patients whose tuberculous destroyed lung is complicated by rheumatic mitral valve disease pose formidable challenges for intraoperative respiratory management and surgical safety, particularly when surgery is performed under cardiopulmonary bypass, the report’s authors note.

Instead of traditional endotracheal intubation, the surgical and anesthesia team chose a visual laryngeal mask airway to maintain the patient’s breathing during the operation. The operation itself consisted of a biological mitral valve replacement, tricuspid annuloplasty, amputation of the left atrial appendage, and pulmonary vein isolation, all carried out under cardiopulmonary bypass.

Despite the patient having only unilateral effective pulmonary ventilation, the team reported that stable oxygenation and ventilation were maintained throughout the entire operation. This outcome is the central technical observation of the case: the visual laryngeal mask served as a workable alternative airway for a patient in whom conventional airway management would have been difficult or hazardous.

The postoperative course was not entirely free of complications. The patient developed a mild right pleural effusion, a collection of fluid around the lung, which was relieved by thoracentesis, a procedure to drain the fluid. However, no severe respiratory complications such as hypoxemia or acute respiratory distress syndrome occurred. She was discharged from the hospital on postoperative day 26.

Follow-up at three months showed good recovery of both cardiac and respiratory function, according to the case report.

Beyond the choice of airway device, the report highlights the importance of multidisciplinary team collaboration and fast-track anesthesia principles. The authors point to preoperative evaluation, surgical planning, intraoperative management, and postoperative complication control as the stages where coordinated specialist input mattered for this patient, whose combined lung and valve disease placed her among the most difficult candidates for cardiac surgery.

As a single case report, the findings describe what was achieved for one patient rather than demonstrating that the technique is effective or safe for others. The article was published as an open-access, peer-reviewed accepted manuscript, and the authors state that it is citable while remaining subject to further editorial revision before the final version of record. Nevertheless, the case adds to the documented options for airway management in cardiac surgery patients whose lungs have been irreversibly damaged by tuberculosis, a population in which every ventilation decision carries substantial weight.

Subject of Research: Use of a visual laryngeal mask airway for intraoperative ventilation during mitral valve surgery in a patient with tuberculous destroyed lung.

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

Article References: Lin, A., Li, H., Cai, X., Lin, J., Zhang, K., Chen, J., Tang, X., Chen, L., Li, R., Zhang, J., & Yang, G. (2026). Visual laryngeal mask for intraoperative ventilation in mitral valve surgery with tuberculous destroyed lung: a case report. BMC Anesthesiology. https://doi.org/10.1186/s12871-026-04336-3

Image Credits: AI Generated

DOI: 10.1186/s12871-026-04336-3

Keywords: tuberculous destroyed lung, visual laryngeal mask airway, mitral valve replacement, cardiopulmonary bypass, airway management, anesthesia, rheumatic mitral valve disease, case report, cardiac surgery, postoperative complications, Visual, laryngeal