title: [A case of pulmonary artery rupture due to pulmonary artery catheter malposition after the weaning of cardiopulmonary bypass].
abstract: An 80-year-old female with aortic regurgitation and angina was scheduled for aortic valve replacement and coronary artery bypass graft. After the induction of anesthesia, central venous catheter and pulmonary artery (PA) catheter were placed into the right internal jugular vein. At the weaning from cardiopulmonary bypass, we noticed pulmonary artery pressure (PAP) on the monitor indicating the PA catheter tip being wedged. Therefore, we pulled the PA catheter until the wedging PAP wave disappeared. However, immediately after repositioning of the PA catheter, massive fresh bleeding was found in the endotracheal tube. We estimated the cause of pulmonary bleeding was PA rupture due to malpositioned PA catheter because surgeons had not manipulated the PA during the operation. Soon after restarting the cardiopulmonary bypass, pulmonary bleeding was stopped. Examination with fiberoptic bronchoscope revealed no further bleeding and weaning from cardiopulmonary bypass was accomplished smoothly. Postoperative course was uneventful.
authors.affiliation: Department of Anesthesia, Oji General Hospital, Tomakomai 053-8506.
authors.forename: Masanori
authors.initials: M
authors.lastname: Watanabe
authors.forename: Masanori
authors.initials: M
authors.lastname: Yamauchi
authors.forename: Sohshi
authors.initials: S
authors.lastname: Iwasaki
authors.forename: Makoto
authors.initials: M
authors.lastname: Asano
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Namiki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002315:Cardiopulmonary Bypass; D002407:Catheterization, Swan-Ganz / Q000009:adverse effects*; D005260:Female; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D008171:Lung Diseases / Q000209:etiology*; D011651:Pulmonary Artery / Q000293:injuries*; D012421:Rupture