Management of catheter-induced pulmonary artery perforation: a rare complication in cardiovascular operations

Conservative management of bronchopulmonary artery perforation without associated haemothorax occurring at thoracentesis: a case report

“…Coil occlusion of a damaged pulmonary artery appears to be a valuable strategy to prevent fatal haemorrhage, 4 and coil embolisation has also been used to treat haemothorax successfully. 5 In a review of the literature, and the experience at their institution of catheter-induced pulmonary artery perforation, Sirivella et al 2 reported that surgical intervention was effective in controlling haemorrhage, but did not reduce the number of deaths. The authors suggested conservative treatment as an option for haemodynamically stable patients without haemothorax.…”

Perforation of the right ventricle by a pulmonary artery catheter that continues to measure cardiac output and mixed venous saturation

“…Perforation of the RV by the PA catheter is seldom reported [8,9] mainly because unlike PA perforation [5][6][7], patients rarely exhibit objective signs and the silent perforations often go unnoticed. In our case, only 50 mL of blood was found within the pericardium 3 hours after perforation.…”

“…However, the use of the catheter is not without risk. A wide range of complications such as pneumothorax [2], air embolism [3], infection [4], and PA perforation [5][6][7] have been reported. However, perforation of the right ventricle (RV) by the PA catheter is a rare finding [8,9].…”

Vorgehen bei einer katheterinduzierten Pulmonalarterienperforation

“…Weitere Maßnahmen zielen auf die Kontrolle der Blutung (Ballonokklusion des Gefäßlecks via A. pulmonalis oder transbronchial [8,12]) oder die arterielle Embolisation mittels Coil [1,9]) ab. Als Ultima Ratio kommt eine pulmonale Resektion in Frage [2,7,14]. Eine Lobektomie führte in einigen Fällen zwar zur Kontrolle der Blutungskomplikationen, konnte aber die Mortalität nicht reduzieren [14].…”