| Treatment of severe pulmonary hemorrhage after cardiopulmonary bypass by selective, temporary balloon occlusion. | |
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MedLine Citation:
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PMID: 15502017 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Ulrich R Döpfmer; Jan-Peter Braun; Joachim Grosse; Holger Hotz; Katja Duveneck; Martin B Schneider |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Anesthesia and analgesia Volume: 99 ISSN: 0003-2999 ISO Abbreviation: Anesth. Analg. Publication Date: 2004 Nov |
Date Detail:
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Created Date: 2004-10-25 Completed Date: 2004-11-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 1310650 Medline TA: Anesth Analg Country: United States |
Other Details:
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Languages: eng Pagination: 1280-2; table of contents Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesiology, Charité Hospital, Lindenstrasse 30, 12589 Berlin, Germany. doepfmer@snafu.de |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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Anesth Analg. 2004 Nov;99(5):1276-9
[PMID:
15502016
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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