Pulmonary Varices in an Adult

Shweihat, Yousef; Zoby, Muneer Al

doi:10.1097/lbr.0000000000000211

Cited by 5 publications

(7 citation statements)

References 7 publications

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“…It is also possible that the airway varices were receiving blood supply through a feeder systemic artery, although we did not find direct angiographic or CT evidence of the same. Shweihat and Zoby [17] reported similar resolution of haemoptysis in an adult with bronchial varices after embolization of feeding arteries, which also resulted in reduction of size of the varices. We also hypothesize that the varices relate to the patient's early surgery and homograft insertion, which failed, resulting in high right atrial pressures and protein‐losing enteropathy.…”

Section: Discussionmentioning

confidence: 91%

Bronchial varices in a child with tricuspid atresia six years post Fontan correction

Bhushan

Goyal

Ward

et al. 2020

Respirology Case Reports

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Tracheal and bronchial varices are rarely found in children. However, they have been described in adults with failing Fontan circuits or secondary to vascular pathology, such as portal and pulmonary hypertension. We report the presentation of haemoptysis and bronchial varices in a child, six years after a Fontan procedure for tricuspid atresia. She had tortuous mediastinal and transpleural arterial collaterals on computed tomography (CT) angiography and cardiac catheterization and subsequently underwent embolization of these collaterals. While the haemoptysis settled post embolization, the bronchial varices persisted on repeat bronchoscopy. She has since been clinically well with no further haemoptysis.

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Section: Discussionmentioning

confidence: 91%

Bronchial varices in a child with tricuspid atresia six years post Fontan correction

Bhushan

Goyal

Ward

et al. 2020

Respirology Case Reports

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“…Intrinsic vascular CAO is the intraluminal obstruction of the airway caused by primary and secondary abnormalities of the central airway vasculature, such as bronchial artery aneurysm [27], bronchial varices [97], bronchial arteriovenous malformation [98,99], and pulmonary artery aneurysm [100], pseudoaneurysm [101], mycotic aneurysm [102], and pulmonary varices [103] (Table 4). The central airway vasculature is a double circulatory system that involves bronchial circulation (a part of systemic circulation) and pulmonary circulation [27].…”

Section: Congenital Vascular Anomaliesmentioning

confidence: 99%

Airway management in vascular central airway obstruction: a literature review

Lee¹,

Chao²,

Hung³

et al. 2021

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Vascular central airway obstruction (CAO) is a rare cause of upper airway obstruction in adults. CAO occurs below the level where it is invisible in a laryngoscope. Doctors therefore should pay attention to the possibilities of vascular CAO when attempting to prevent and resolve catastrophic complications from upper airway obstruction such as cardiorespiratory collapse and hemoptysis, which requires a thoughtful preoperative planning of airway management before starting a surgical reconstruction.

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“…The effect of prone positioning on the natural airway drainage may have led to the improvement of posterior lung ventilation. Embolization of a bronchial artery on a bleeding bronchial varix has been reported by Shweihat and Zoby [2]. Likewise, this hypothesis of enhance airway drainage with the prone position in pulmonary hemorrhage is discussed only on very limited case reports [3,4].…”

Section: Introductionmentioning

confidence: 96%

“…Treatment is usually unnecessary unless varix rapidly increases in size or complication such as hemoptysis, thromboembolic disease, or rupture occurs. In the report by Shweihat and Zoby on a young patient with recurrent hemoptysis, embolization of the artery resulted in the control of the hemoptysis and reduction in size of the varices on subsequent bronchoscopic evaluation [2]. Arterial embolization indicates that the increase in flow from the feeding vessel is the predominant pathology on a patient's bronchial varices.…”

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confidence: 96%

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Massive Pulmonary Hemorrhage from Bronchial Varix

Agustin

Shay

González

et al. 2020

Case Reports in Pulmonology

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Bronchial varix is a rare pulmonary disorder which may lead to life-threatening hemorrhage. Diagnosis is difficult because of the subtle abnormalities on radiographic and bronchoscopic examination. We present a case of massive hemoptysis from a bleeding bronchial varix. In the absence of immediate complex endobronchial therapy in the island of Guam, this case was initially managed with nebulized and intravenous tranexamic acid. This was followed by endobronchial blockade of the bleeding airway with endobronchial epinephrine instillation. Selective bronchial artery embolization alleviated the acute-phase bleeding. Prone positioning was initiated due to severe hypoxia after blood clots compromised the patency of bilateral bronchial airways. Prone ventilation was employed for 17 hours for 2 consecutive days with intermittent bronchoscopic forceps extraction of airway blood clots while in the prone position. These maneuvers resulted to improved lung ventilation and oxygenation. The patient underwent bronchial sleeve resection surgery for definitive management.

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Pulmonary Varices in an Adult

Cited by 5 publications

References 7 publications

Bronchial varices in a child with tricuspid atresia six years post Fontan correction

Bronchial varices in a child with tricuspid atresia six years post Fontan correction

Airway management in vascular central airway obstruction: a literature review

Massive Pulmonary Hemorrhage from Bronchial Varix

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