Portal de Periódicos da CAPES

Iatrogenic pulmonary artery rupture

2007; Lippincott Williams & Wilkins; Volume: 20; Issue: 1 Linguagem: Inglês

10.1097/aco.0b013e32801158a9

1473-6500

Jean S. Bussières,

Congenital Heart Disease Studies

Pulmonary artery rupture is probably the most devastating complication associated with the use of the pulmonary artery catheter. This rare but disastrous situation requires a clear intervention plan.The initial presentation of pulmonary artery ruptures may be as obvious as a massive pulmonary hemorrhage or as subtle as a cough associated with minimal hemoptysis, or it may even be totally asymptomatic. A patient presenting any clinical manifestation of pulmonary artery rupture may develop a pulmonary artery false aneurysm, which is the accumulation of blood in an aneurismal sac compressed by lung parenchyma. This condition requires intervention because delayed hemorrhage may occur and recurrence can be massive and fatal. Following an initial episode of suspected pulmonary artery rupture, the patient should undergo immediate radiological investigation. If a diagnosis of pulmonary artery false aneurysm is confirmed, selective angiographic embolization helps reduce morbidity and mortality.The incidence of pulmonary artery ruptures is probably underestimated because many hemoptysis episodes or radiological infiltrations associated with pulmonary artery catheter use are not investigated. Also, the natural evolution of the pulmonary artery false aneurysm is unknown. The incidence of spontaneous healing, bleeding recurrence or asymptomatic persistence is unknown following formation of a pulmonary artery false aneurysm.