Life-threatening hemorrhage from inadvertent cervical arteriotomy.
Catastrophic hemorrhage followed accidental puncture of the carotid artery or its branches during attempted preoperative insertion of flow-directed balloon-tipped pulmonary artery catheters in 2 patients who underwent open cardiac procedures. Direct repair of two carotid artery lacerations was necessary in 1 patient; the second patient slowly resorbed a large extrapleural hematoma without surgical intervention. This experience suggests that patients experiencing such seemingly innocuous but potentially disastrous arterial injuries should not be heparinized, and that any procedure involving cardiopulmonary bypass should be postponed for several days to allow safe healing of the laceration.
D000787:Angina Pectoris / Q000150:complications / Q000601:surgery; D006328:Cardiac Catheterization / Q000009:adverse effects*; D002315:Cardiopulmonary Bypass; D002339:Carotid Arteries / Q000601:surgery; D020212:Carotid Artery Injuries; D005260:Female; D006350:Heart Valve Prosthesis; D006470:Hemorrhage / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007601:Jugular Veins / Q000601:surgery; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000601:surgery; D009333:Neck; D011654:Pulmonary Edema / Q000150:complications / Q000601:surgery