Pulmonary artery rupture during right heart catheterization: successful endovascular treatment with Amplatzer Vascular Plug

Landi, Antonio; Fovino, Luca Nai; Fabris, Tommaso; Napodano, Massimo

doi:10.1093/eurheartj/ehy400

Cited by 2 publications

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“…[10] This device has been successfully used in the pulmonary arteries in Behçet's disease, Hughes-Stovin syndrome, iatrogenic PA aneurysms, idiopathic aneurysms and pulmonary arteriovenous malformations (AVMs), among others. [11][12][13] However, to our knowledge this is the only series of Rasmussen aneurysms managed with the AVP to date.…”

Section: Discussionmentioning

confidence: 96%

Issues in Medicine

Shaw

John²,

Koegelenberg³

et al. 2023

S Afr Med J

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Rasmussen aneurysms are abnormalities of the pulmonary arterial system caused by tuberculosis (TB). They are associated with a highmortality rate when they cause life-threatening haemoptysis. High TB-prevalence regions have a large burden of TB-related haemoptysisbut often limited resources. This series of 25 patients who presented with life-threatening haemoptysis from current and/or previous TBwere found to have abnormal pulmonary arteries on computed tomography pulmonary angiogram (CTPA), which were judged to belikely contributors to their bleeding, either in isolation or with concomitant abnormal bronchial or systemic vasculature. These patientsunderwent transcatheter placement of Amplatzer vascular plugs in the feeder pulmonary artery. Bronchial and systemic lesions wereaddressed separately as needed. Immediate technical success was achieved in all patients, but four of them experienced intraoperativehaemoptysis related to dislodgement of the occluding platelet plug by the high-pressure automatic injector and wire. At 48 hours after theprocedure, 18 (72%) remained haemoptysis-free. Six of these experienced recurrence within 1 year of their procedure. Pulmonary arteryplacement of an Amplatzer vascular plug is a feasible option for treating bleeding Rasmussen aneurysms, but should be part of a combinedapproach to addressing suspected culprit vascular lesions in all intrathoracic vascular systems.

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Section: Discussionmentioning

confidence: 96%

Issues in Medicine

Shaw

John²,

Koegelenberg³

et al. 2023

S Afr Med J

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Iatrogenic perforation of a pulmonary artery side branch—a case report

Leick

Leinen

Friedrich

et al. 2021

European Heart Journal - Case Reports

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Background The use of a pulmonary artery catheter (PAC) continues to be important for the diagnosis and therapeutic control of severe heart failure and in the diagnosis of pulmonary arterial hypertension. One of the most feared complications of this examination is perforation of a pulmonary artery with an estimated incidence of 0.031–0.05% and mortality rates of up to 70%. Case summary We report on an 80-year-old female patient who experienced a perforation of a pulmonary artery branch during the work-up of pulmonary arterial hypertension by PAC. Immediately after the perforation, haemodynamic shock developed rapidly, necessitating cardiopulmonary resuscitation. Occlusion of the pulmonary artery branch with a semicompliant balloon was applied immediately. After 40 min of occlusion, the bleeding persisted, and endovascular coil implantation was performed. Subsequently, the bleeding stopped, and the haemodynamics stabilized. After treatment, the patient was discharged home without any significant sequelae. Discussion Treatment options in pulmonary artery perforation are limited, especially if the patient is inoperable and if balloon occlusion fails. Based on our results, endovascular coil embolization can be considered a therapeutic option.

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Pulmonary artery rupture during right heart catheterization: successful endovascular treatment with Amplatzer Vascular Plug

Cited by 2 publications

References 0 publications

Issues in Medicine

Issues in Medicine

Iatrogenic perforation of a pulmonary artery side branch—a case report

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