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Ann Thorac Surg 1991;51:304-306
© 1991 The Society of Thoracic Surgeons

Articles

Intraoperative management of severe endobronchial hemorrhage

Cemil M. Purut, MDa,b, Stewart M. Scott, MDa,b, John V. Parham, MDa,b, Peter K. Smith, MD*,a,b

a Department of Surgery, Duke University Medical Center, Durham USA
b Department of Surgery, Veterans Affairs Medical Center, Asheville, North Carolina USA

Accepted for publication July 23, 1990.

* Address reprint requests to Dr Smith, Duke University Medical Center, Box 3442, Durham, NC 27710.

Endobronchial hemorrhage due to pulmonary artery perforation by a Swan-Ganz catheter developed during coronary artery bypass grafting while weaning from cardiopulmonary bypass. After reinstitution of cardiopulmonary bypass with pulmonary artery venting, bleeding was localized to the right lower lobe bronchus using fiberoptic bronchoscopy. A Fogarty embolectomy catheter was inflated in the bronchus to tamponade successfully only the right lower lobe. This case illustrates a method of distal bronchial blockade for maximal retention of pulmonary function and avoidance of pulmonary resection.




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