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Bronchial artery hypertrophy-associated perioperative pulmonary hemorrhage in cardiovascular surgery : a case report
| Title: | Bronchial artery hypertrophy-associated perioperative pulmonary hemorrhage in cardiovascular surgery : a case report |
| Authors: | Abe, Shinji Browse this author | | Kamikubo, Yasuhiro Browse this author | | Kato, Nobuyasu Browse this author | | Kato, Hiroki Browse this author | | Ooka, Tomonori Browse this author →KAKEN DB | | Shingu, Yasushige Browse this author →KAKEN DB | | Wakasa, Satoru Browse this author →KAKEN DB |
| Keywords: | Bronchial artery hypertrophy | | Pulmonary hemorrhage | | Embolization |
| Issue Date: | 29-Apr-2022 |
| Publisher: | Springer |
| Journal Title: | Surgical case reports |
| Volume: | 8 |
| Issue: | 1 |
| Start Page: | 80 |
| Publisher DOI: | 10.1186/s40792-022-01432-7 |
| Abstract: | Background Pulmonary hemorrhage is a life-threatening complication of cardiovascular surgery. Bronchial artery hypertrophy, a rare pathology associated with inflammatory and ischemic respiratory diseases, increases the risk of pulmonary hemorrhage; however, its involvement in cardiovascular surgery is not well known. We present two cardiovascular surgical cases in which embolization of the hypertrophied bronchial artery was effective in controlling perioperative pulmonary hemorrhage. Case presentation The first case was a 51-year-old man with chronic obstructive pulmonary disease who developed acute type A aortic dissection. After emergent surgery, his blood pressure suddenly dropped in the intensive care unit; computed tomography revealed a right hemothorax. Because a 4-mm dilated bronchial artery was identified on preoperative computed tomography, the hemothorax was suspected to be associated with bronchial artery hypertrophy. Selective bronchial arteriography was emergently performed and revealed a right pulmonary parenchymal blush. After subsequent coil embolization of the bronchial artery, the parenchymal blush disappeared, and his hemodynamic condition stabilized. The second case was a 66-year-old man with bronchiectasis who was referred for redo aortic valve replacement due to structural valve deterioration. A bioprosthesis was previously implanted to avoid permanent anticoagulation because the patient had repeated episodes of hemoptysis; however, he still had persistent hemosputum during admission for the redo aortic valve replacement. A dilated bronchial artery 3.7 mm in size was incidentally identified on preoperative computed tomography, and hence, the repeated hemosputum was suspected to be associated with bronchial artery hypertrophy. Bronchial arteriography revealed a right pulmonary parenchymal blush, and prophylactic embolization of the bronchial artery was performed. The hemosputum disappeared after the procedure, and redo aortic valve replacement was performed uneventfully 8 days later. Conclusion In cardiovascular surgery, the risk of pulmonary hemorrhage associated with bronchial artery hypertrophy should be considered, especially in patients with inflammatory and ischemic respiratory diseases. |
| Type: | article |
| URI: | http://hdl.handle.net/2115/85694 |
| Appears in Collections: | 医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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