Intraoperative management of severe endobronchial hemorrhage.
Endobronchial hemorrhage due to pulmonary artery perforation by a Swan-Ganz catheter developed during coronary artery bypass grafting while weaning from cardiopulmonary bypass. After reinstitution of cardio-pulmonary bypass with pulmonary artery venting, bleeding was localized to the right lower lobe bronchus using fiberoptic bronchoscopy. A Fogarty embolectomy catheter was inflated in the bronchus to tamponade successfully only the right lower lobe. This case illustrates a method of distal bronchial blockade for maximal retention of pulmonary function and avoidance of pulmonary resection.
Purut
C M
CM
Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710.
Scott
S M
SM
Parham
J V
JV
Smith
P K
PK
D016063:Blood Loss, Surgical; D001982:Bronchial Diseases / Q000209:etiology / Q000628:therapy*; D001999:Bronchoscopy; D002407:Catheterization, Swan-Ganz / Q000009:adverse effects*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D006801:Humans; D007431:Intraoperative Complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000293:injuries*; D012421:Rupture