Document Detail


Treatment of severe pulmonary hemorrhage after cardiopulmonary bypass by selective, temporary balloon occlusion.
MedLine Citation:
PMID:  15502017     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Severe pulmonary bleeding causes frequent mortality, particularly if this event occurs during separation from extracorporeal circulation during cardiac surgery. We present a new approach to treat this life-threatening complication: temporary balloon occlusion of the pulmonary artery feeding the involved lobe. On attempting to wean a 71-yr-old female patient from cardiopulmonary bypass after aortic valve replacement, she lost more than 2 L of blood through her trachea over approximately 15 min and severe gas embolism into the left atrium was visualized on transesophageal echocardiography. As the bleeding was too vigorous to be localized by fiberoptic bronchoscopy, an interventional cardiologist was consulted. After localizing the affected lobe using fluoroscopy, he inflated a balloon dilating catheter in the lower lobe artery. This effectively stopped the bleeding. Separation from extracorporeal circulation was uneventful using one-lung ventilation to prevent further gas embolism. Sixteen hours after the end of surgery the catheter could be deflated and removed without any further intervention. The patient made an excellent recovery.
Authors:
Ulrich R Döpfmer; Jan-Peter Braun; Joachim Grosse; Holger Hotz; Katja Duveneck; Martin B Schneider
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  99     ISSN:  0003-2999     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-10-25     Completed Date:  2004-11-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1280-2; table of contents     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, Charité Hospital, Lindenstrasse 30, 12589 Berlin, Germany. doepfmer@snafu.de
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MeSH Terms
Descriptor/Qualifier:
Balloon Occlusion*
Cardiopulmonary Bypass / adverse effects*
Echocardiography, Transesophageal
Embolism, Air / prevention & control,  radiography
Female
Heart Valve Prosthesis Implantation
Humans
Lung Diseases / etiology,  radiography,  therapy*
Middle Aged
Postoperative Hemorrhage / radiography,  therapy*
Respiration, Artificial
Tomography, X-Ray Computed
Comments/Corrections
Comment In:
Anesth Analg. 2004 Nov;99(5):1276-9   [PMID:  15502016 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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