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Ann Thorac Surg 1977;24:233-236
© 1977 The Society of Thoracic Surgeons

Articles

Life-Threatening Hemorrhage from Inadvertent Cervical Arteriotomy

M. Terry McEnany, M.D.*, W. Gerald Austen, M.D.

From the Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA

Accepted for publication March 21, 1977.

* Address reprint requests to Dr. McEnany, Department of Surgery, The Miriam Hospital, Providence, RI 02906

Catastrophic hemorrhage followed accidental puncture of the carotid artery or its branches during attempted preoperative insertion of flow-directed balloon-tipped pulmonary artery catheters in 2 patients who underwent open cardiac procedures. Direct repair of two carotid artery lacerations was necessary in 1 patient; the second patient slowly resorbed a large extrapleural hematoma without surgical intervention. This experience suggests that patients experiencing such seemingly innocuous but potentially disastrous arterial injuries should not be heparinized, and that any procedure involving cardiopulmonary bypass should be postponed for several days to allow safe healing of the laceration.




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