HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): John D. Urschel Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Urschel, J. D. Articles by Myerowitz, P. D. Search for Related Content PubMed PubMed Citation Articles by Urschel, J. D. Articles by Myerowitz, P. D.

Ann Thorac Surg 1993;56:585-589
© 1993 The Society of Thoracic Surgeons

---

Articles

Catheter-induced pulmonary artery rupture in the setting of cardiopulmonary bypass

^a Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
^b Department of Surgery, Ohio State University, Columbus, Ohio USA

^_* Address reprint requests to Dr Urschel, Department of Surgical Oncology, Roswell Park Cancer Institute, Elm and Carlton Sts, Buffalo, NY 14263-0001.

Pulmonary artery rupture is an infrequent complication of flow-directed catheters. Because cardiopulmonary bypass offers an opportunity for control of gas exchange and hemorrhage, pulmonary artery rupture in this setting is different from that occurring in the intensive care unit and catheterization laboratory. A collective review of 30 published cases was conducted. Sixty-nine percent of patients were female and 50% had valvular heart disease. The right pulmonary artery was injured in 93% of cases. Arterial rupture presented with airway hemorrhage in 29 of 30 patients. Six patients presented with a herald airway bleed after catheter insertion but before operation. Three of 4 patients died when operation was performed in the face of a herald bleed. Airway hemorrhage most commonly developed during bypass weaning (19 cases). Recurrent hemorrhage occurred in 45% of patients ([equation]) treated conservatively compared wish 0% ([equation]) in those having surgical control of bleeding (p = 0.07). Three patients died in the operating room. Overall mortality was 41%. Uncontrolled hemorrhage was the leading cause of death. Conservative management strategies are associated with a high incidence of secondary, often fatal, hemorrhage. Although pulmonary resection controls bleeding, mortality from other causes is a problem. A treatment protocol is proposed that considers these management dilemmas.

This article has been cited by other articles:

				P. J. Neuburger, A. C. Galloway, M. D. Zervos, and M. S. Kanchuger Case Report: Separation from Cardiopulmonary Bypass with a Rigid Bronchoscope Airway After Hemoptysis and Bronchial Impaction with Clot Anesth. Analg., January 1, 2012; 114(1): 89 - 92. [Abstract] [Full Text] [PDF]

				A. Sam and S. Sandur An Iatrogenic Lung Nodule Chest, July 1, 2009; 136(1): 314 - 317. [Full Text] [PDF]

				R. Bianchini, G. Melina, U. Benedetto, M. Rossi, B. Fiorani, M. Iasenzaniro, and R. Sinatra Extracorporeal Membrane Oxygenation for Swan-Ganz Induced Intraoperative Hemorrhage Ann. Thorac. Surg., June 1, 2007; 83(6): 2213 - 2214. [Abstract] [Full Text] [PDF]

				C. K. Choong and B. F. Meyers Lung mass after pulmonary artery catheterization: Beware of the pulmonary artery false aneurysm J. Thorac. Cardiovasc. Surg., September 1, 2005; 130(3): 899 - 900. [Full Text] [PDF]

				Y.-K. Chao, Y.-H. Liu, M.-J. Hsieh, Y.-C. Wu, H.-P. Liu, C.-J. Wang, and P.-J. Ko Controlling difficult airway by rigid bronchoscope--an old but effective method Interact CardioVasc Thorac Surg, June 1, 2005; 4(3): 175 - 179. [Abstract] [Full Text] [PDF]

				G. Stratmann and J. L. Benumof Endobronchial Hemorrhage Due to Pulmonary Circulation Tear: Separating the Lungs and the Air from the Blood Anesth. Analg., November 1, 2004; 99(5): 1276 - 1279. [Full Text] [PDF]

				U. R. Dopfmer, J.-P. Braun, J. Grosse, H. Hotz, K. Duveneck, and M. B. Schneider Treatment of Severe Pulmonary Hemorrhage After Cardiopulmonary Bypass by Selective, Temporary Balloon Occlusion Anesth. Analg., November 1, 2004; 99(5): 1280 - 1282. [Abstract] [Full Text] [PDF]

				S. Sirivella, I. Gielchinsky, and V. Parsonnet Management of catheter-induced pulmonary artery perforation: a rare complication in cardiovascular operations Ann. Thorac. Surg., December 1, 2001; 72(6): 2056 - 2059. [Abstract] [Full Text] [PDF]

				M. R. Poplausky, G. Rozenblit, J. H. Rundback, G. Crea, S. Maddineni, and R. Leonardo Swan-Ganz Catheter-Induced Pulmonary Artery Pseudoaneurysm Formation : Three Case Reports and a Review of the Literature Chest, December 1, 2001; 120(6): 2105 - 2111. [Abstract] [Full Text] [PDF]

				J. D. Urschel and T. A. Salerno Management of exsanguinating hemoptysis during cardiopulmonary bypass Ann. Thorac. Surg., December 1, 1999; 68(6): 2386 - 2386. [Full Text] [PDF]

				M. H. Mullerworth, P. Angelopoulos, M. A. Couyant, A. M. Horton, S. M. Robinson, O. U. Petring, P. J. Mitchell, and J. J. Presneill Recognition and management of catheter-induced pulmonary artery rupture Ann. Thorac. Surg., October 1, 1998; 66(4): 1242 - 1245. [Abstract] [Full Text] [PDF]

				S. Shimokawa, K. Uehara, H. Toyohira, H. Saigenji, Y. Moriyama, A. Taira, and K. Miyahara Massive Endobronchial Hemorrhage After Pulmonary Embolectomy Ann. Thorac. Surg., April 1, 1996; 61(4): 1241 - 1242. [Abstract] [Full Text]

				M. D. Horowitz and L. A. Roder Pulmonary artery rupture Ann. Thorac. Surg., February 1, 1994; 57(2): 524 - 524. [PDF]