title: Catastrophic haemoptysis in the Fontan circulation--a novel surgical approach to denude the culprit bleeding vessels.
abstract: We describe the case of a young man aged 19 years with a double inlet left ventricle associated with transposition of the great arteries, and a mechanical aortic valve requiring anticoagulation, who presented with massive haemoptysis. At cardiac catheterisation, there were multiple feeder vessels to a bleeding leash surrounding and communicating with his left main bronchus. Despite occlusion of the larger feeder vessels, he continued to have massive haemoptysis. We describe a novel surgical strategy of denuding the peribronchial vessels through a left lateral thoracotomy. This successfully stopped his bleeding.
authors.affiliation: Department of Adult Congenital Heart disease and Interventional Radiology, Southampton University Hospital, Southampton, United Kingdom.
authors.forename: David E
authors.initials: DE
authors.lastname: Black
authors.forename: Gruschen R
authors.initials: GR
authors.lastname: Veldtman
authors.forename: Timothy
authors.initials: T
authors.lastname: Bryant
authors.forename: John
authors.initials: J
authors.lastname: Miller
authors.forename: Marcus
authors.initials: M
authors.lastname: Haw
mesh_terms: D001980:Bronchi / Q000098:blood supply* / Q000601:surgery; D006328:Cardiac Catheterization / Q000379:methods; D006348:Cardiac Surgical Procedures / Q000379:methods; D016638:Critical Illness; D004310:Double Outlet Right Ventricle / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D004322:Drainage / Q000379:methods; D004630:Emergencies; D005500:Follow-Up Studies; D018729:Fontan Procedure / Q000009:adverse effects* / Q000379:methods; D006469:Hemoptysis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008026:Ligation / Q000379:methods; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D012086:Reoperation / Q000379:methods; D018570:Risk Assessment; D013908:Thoracotomy / Q000379:methods; D013997:Time Factors; D014188:Transposition of Great Vessels / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult