[Massive Pulmonary Hemorrhage During Cardiac Operation;Report of a Case].

ABSTRACT

The incidence of pulmonary hemorrhage during cardiac operation is not freqent but one of severe and lethal complications. We report a case of massive pulmonary hemorrhage, hemoptysis, suspected to be induced by a Swan-Ganz catheter. The patient had satisfactory progress postoperatively. An 80-year-old female patient underwent mitral valve replacement, tricuspid annuloplasty, and maze procedure. A Swan-Ganz catheter was inserted via the right jugular vein and fixed just at 40 cm as in usual preoperative induction. Operative procedures were uneventful, but active and massive airway hemorrhage started while weaning off cardiopulmonary bypass. A hematoma spreading under the visceral pleura of the right middle-lobe lung was found. We immediately replaced the endotracheal tube with a double-lumen one, and promptly decided to do lung lobectomy. These strategies were very helpful to rescue the patient, and led to her good recovery after the severe pulmonary hemorrhage, possibly induced by a catheter.