Massive Endobronchial Hemorrhage after Cardiopulmonary Bypass Treated by Selective Bronchial Tamponade with a Bronchial Blocker Tube / 日本心臓血管外科学会雑誌

ABSTRACT

We report a case of massive endobronchial hemorrhage after cardiopulmonary bypass, and its successful treatment utilizing a bronchial blocker tube without circulatory support. An 85-year-old woman underwent mitral and tricuspid valves repair for mitral stenosis and regurgitation, and tricuspid regurgitation. The repairs were performed uneventfully. The patient was weaned from cardiopulmonary bypass. After protamine infusion, massive endobronchial hemorrhage occurred through the tracheal tube. On fiberoptic bronchoscopy, prompt identification and selective occlusion of the hemorrhage source was performed by a Coopdech endobronchial blocker tube (Daiken Medical Co., Ltd, Osaka, Japan). Postoperative contrast-enhanced computed tomography revealed thrombogenic pseudoaneurysm of the right middle lobe pulmonary artery. We speculated that Swan-Ganz catheters induced endobronchial hemorrhage. The patient did not experience any further hemorrhage. She was discharged from our hospital on the 25th postoperative day in good condition.