scholarly journals Intrabronchial migration of hemostatic agent through a bronchial fistula after lung transplantation: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yuya Nobori ◽  
Masaaki Sato ◽  
Yasutaka Hirata ◽  
Haruo Yamauchi ◽  
Chihiro Konoeda ◽  
...  
Keyword(s):  
Foreign Body ◽  
Pulmonary Artery ◽  
Lung Transplantation ◽  
Treatment Options ◽  
Left Pulmonary Artery ◽  
Exceptional Case ◽  
Hemostatic Agent ◽  
Bypass Grafting ◽  
Bronchial Fistula ◽  
Bronchial Anastomosis

Abstract Background A bronchial fistula is a relatively rare and potentially fatal complication after lung transplantation. Thoracic surgeons and pulmonologists often face challenges when selecting treatment options. We herein report an exceptional case of intrabronchial migration of a nonabsorbable hemostatic agent, which had been placed around the pulmonary artery at the time of lung transplantation, through a bronchial fistula. Case presentation A 61-year-old man developed respiratory distress 1 year after left single-lung transplantation for idiopathic interstitial pneumonia. Bronchoscopic examination revealed an apparent foreign body protruding from the mediastinum into the distal site of the bronchial anastomosis. The foreign body was easily removed bronchoscopically and appeared to be a hemostatic agent that had been placed during the previous lung transplantation. The patient developed a similar clinical episode and finally developed hemoptysis. Computed tomography revealed a foreign body located between the bronchus and pulmonary artery, partially protruding into the bronchial lumen. Given the possibility of a bronchopulmonary arterial fistula, surgical treatment was performed. The foreign body was located between the bronchus and left pulmonary artery and was easily removed. Multiple bronchial fistulas were found, and all were closed with direct sutures. Bypass grafting of the left pulmonary artery was then performed, initially with a homograft but eventually with an extended polytetrafluoroethylene graft. The patient was finally discharged 5 months after the surgery. Conclusion We experienced an extremely rare case of intrabronchial migration of hemostatic agents used during the previous lung transplantation through a bronchial fistula, which were successfully managed by direct bronchial closure and bypass grafting of the left pulmonary artery.

scholarly journals Successful stenting of anastomotic stenosis of the left pulmonary artery after single lung transplantation

2011 ◽  
Vol 20 (119) ◽  
pp. 059-62 ◽  
Author(s):  
S. K. Banerjee ◽  
K. Santhanakrishnan ◽  
L. Shapiro ◽  
J. Dunning ◽  
S. Tsui ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Lung Transplantation ◽  
Left Pulmonary Artery ◽  
Anastomotic Stenosis ◽  
Single Lung Transplantation

scholarly journals Idopathic Pulmonary Hypertension Mimicking Pulmonary Veno-Occlusive Disease – A Case Report.

2016 ◽  
Vol 01 (03) ◽  
pp. 029-032
Author(s):  
K. Prasad ◽  
A. Kumar
Keyword(s):  
Pulmonary Hypertension ◽  
Case Report ◽  
Pulmonary Artery ◽  
Lung Transplantation ◽  
Treatment Options ◽  
Pulmonary Artery Hypertension ◽  
Occlusive Disease ◽  
Idiopathic Pulmonary Hypertension ◽  
Worse Prognosis

AbstractPVOD is rare cause of pulmonary artery hypertension which is associated with worse prognosis and limited treatment options apart from lung transplantation. Differentiating IPAH patients from PVOD is sometimes difficult relying on catheterization data alone. But differentiation between these two diseases is important as there are many evolved treatment options for IPAH. Here we are reporting a case of IPAH where catheterization data shows conflicting results which on further evaluation diagnosis confirmed as idiopathic pulmonary hypertension.

scholarly journals Anastomotic stenosis of the left pulmonary artery after lung transplantation: treatment by percutaneous placement of an endoprosthesis.

1993 ◽  
Vol 161 (5) ◽  
pp. 947-949 ◽  
Author(s):  
J Y Gaubert ◽  
G Moulin ◽  
P Thomas ◽  
M Reynaud-Gaubert ◽  
M Noirclerc ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Lung Transplantation ◽  
Left Pulmonary Artery ◽  
Anastomotic Stenosis

Modified Pulmonary Artery to Left Atrium Bypass as Bridge to Lung Transplantation in Pulmonary Artery Hypertension

2015 ◽  
Vol 63 (S 01) ◽  
Author(s):  
N. Patil ◽  
A. Weymann ◽  
A. Sabashnikov ◽  
A.-F. Popov ◽  
A. Simon
Keyword(s):  
Pulmonary Artery ◽  
Lung Transplantation ◽  
Left Atrium ◽  
Pulmonary Artery Hypertension

Unintended Pulmonary Artery Ligation during PDA Ligation

2016 ◽  
Vol 19 (4) ◽  
pp. 187 ◽  
Author(s):  
Dohun Kim ◽  
Si-Wook Kim ◽  
Hong-Ju Shin ◽  
Jong-Myeon Hong ◽  
Ji Hyuk Lee ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Ductus Arteriosus ◽  
Left Lung ◽  
Left Pulmonary Artery ◽  
Chest Ct ◽  
Mechanical Ventilator ◽  
Artery Ligation ◽  
Ventilator Support ◽  
Surgical Ligation ◽  
Emergent Operation

A 10-day-old boy was transferred to our hospital due to tachypnea. Patent ductus arteriosus (PDA), 4.8 mm in diameter, with small ASD was diagnosed on echocardiography. Surgical ligation of the ductus was performed after failure of three cycles of ibuprofen. However, the ductus remained open on routine postoperative echocardiography on the second postoperative day, and chest CT revealed inadvertent ligation of the left pulmonary artery (LPA) rather than the PDA. Emergent operation successfully reopened the clipped LPA and ligated the ductus on the same (second postoperative) day.<br />Mechanical ventilator support was weaned on postoperative day 21, and the baby was discharged on postoperative day 47 with a normal left lung shadow.

Managing Port-Site Bleeding during Less Invasive Coronary Artery Bypass Grafting

2012 ◽  
Vol 15 (5) ◽  
pp. 272 ◽  
Author(s):  
Soroosh Kiani ◽  
Mary-Lynn Brecht ◽  
Katherine Lovinger ◽  
Robert S. Poston
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Risk Score ◽  
Chest Tube ◽  
Artery Bypass ◽  
Hemostatic Agent ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Port Access

<p><b>Introduction:</b> Robotic-assisted coronary artery bypass grafting (r-CABG) requires the placement of ports bluntly through the chest wall. When removed, these ports create bleeding sites that can be difficult to detect and treat. This study evaluated whether a topical hemostatic agent placed locally within these sites helps to reduce bleeding and blood product requirements.</p><p><b>Methods:</b> We retrospectively analyzed outcomes for r-CABG cases where 5 mL of a flowable hemostatic agent was injected locally within all port sites (hemostat group, n = 62) compared with patients whose port sites were untreated (controls, n = 131). Outcomes included chest tube output, red blood cell (RBC) transfusions, length of hospital stay, and the risk of reoperation for bleeding. Analyses were adjusted for risk factors known to influence bleeding and Society of Thoracic Surgeons (STS) risk score as a weighted composite of variables, which controls for patient and clinical variables.</p><p><b>Results:</b> The 2 study groups had similar baseline characteristics and underwent the same r-CABG procedure. The hemostat group had significant reductions in RBC transfusion (24.2% versus 40.8% receiving blood; <i>P</i> = .026; 0.44 versus 1.39 U transfused postoperatively, <i>P</i> = .024). After adjustment for bleeding risks (using STS risk score), differences in transfusions remained significant. Reoperation rates for bleeding, length of stay, chest tube drainage, and intraoperative transfusions were not significantly different in the 2 groups.</p><p><b>Conclusions:</b> There was significantly reduced postoperative bleeding and less exposure to blood products in the hemostat group. These findings suggest that undetected bleeding from sites used for port access serves as an underappreciated source of morbidity after r-CABG.</p>

Ligation of left pulmonary artery instead of patent ductus arteriosus

2020 ◽  
Vol 30 (12) ◽  
pp. 1943-1945
Author(s):  
Semih Murat Yucel ◽  
Irfan Oguz Sahin
Keyword(s):  
Surgical Treatment ◽  
Pulmonary Artery ◽  
Patent Ductus Arteriosus ◽  
Surgical Complication ◽  
Ductus Arteriosus ◽  
Left Pulmonary Artery ◽  
Artery Ligation ◽  
Surgical Closure ◽  
Post Operative Period ◽  
Patent Ductus

AbstractDuctus arteriosus is an essential component of fetal circulation. Due to occurring changes in the cardiopulmonary system physiology after birth, ductus arteriosus closes. Patent ductus arteriosus can be closed by medical or invasive (percutaneous or surgical) treatment methods. Percutaneous or surgical closure of patent ductus arteriosus can be performed for the cases that medical closure failed. Surgical treatment is often preferred method for closure of patent ductus arteriosus in the neonatal period. The most common surgical complications are pneumothorax, recurrent laryngeal nerve injury, bleeding, and recanalisation. A very rare surgical complication is left pulmonary artery ligation that has been presented in a few cases in the literature. Echocardiography control should be performed in the early post-operative period, especially in patients with clinical suspicion. If reoperation is required, it should never be delayed. We report a newborn patient whose left pulmonary artery ligated accidentally during patent ductus arteriosus closure surgery and surgical correction of this complication at the early post-operative period.

scholarly journals Spontaneous pulmonary artery thrombus in a neonate

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Y. S. Shrimanth ◽  
Krishna Prasad ◽  
Adari Appala Karhtik ◽  
Parag Barwad ◽  
C. R. Pruthvi ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Respiratory Distress ◽  
Disease Risk ◽  
Maternal Diabetes ◽  
Left Pulmonary Artery ◽  
Pulmonary Angiography ◽  
Haemodynamic Instability ◽  
Artery Thrombosis ◽  
Heart Disease Risk Factors ◽  
Heart Disease Risk

Abstract Background Pulmonary artery thrombosis is rare in neonates and mimics as persistent pulmonary hypertension or congenital heart disease. Risk factors include septicemia, dehydration, polycythemia, maternal diabetes, asphyxia, and inherited thrombophilias. They present with cyanosis and respiratory distress. Careful echocardiogram assessment helps in identifying the thrombus in the pulmonary artery and its branches. Computed tomography pulmonary angiography confirms the diagnosis. Case presentation We present a case of term neonate who presented with respiratory distress and cyanosis and a detailed echocardiogram revealed thrombus in the origin of left pulmonary artery. The neonate was managed initially with unfractionated heparin and later with low molecular weight heparin with which there was significant resolution of the thrombus Conclusion Spontaneous pulmonary artery thrombosis though rare should be suspected in any cyanotic neonate with respiratory distress. Management in these cases depends on the haemodynamic instability and lung ischemia.

Type 2 bridging bronchus with left pulmonary artery sling

2021 ◽  
pp. 1-3
Author(s):  
Amna Al-Arnawoot ◽  
John Kavanagh ◽  
Elsie T. Nguyen
Keyword(s):  
Pulmonary Artery ◽  
Male Patient ◽  
Adult Male ◽  
Left Pulmonary Artery ◽  
Pulmonary Artery Sling ◽  
Bridging Bronchus ◽  
Left Pulmonary Artery Sling ◽  
Airway Anomalies ◽  
Adult Male Patient

Abstract Bridging bronchi are the rarest of the major airway anomalies reported in the literature. In this brief report, we present a case of a symptomatic adult male patient presenting with a type 2 bridging bronchus associated with left pulmonary artery sling.

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