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Massive Pulmonary Hemorrhage After Pulmonary Thromboendarterectomy

Manecke, Gerard R. Jr. MD*; Kotzur, Andreas MD†; Atkins, Gus MD*; Fedullo, Peter F. MD‡; Auger, William R. MD‡; Kapelanski, David P. MD§; Jamieson, Stuart W. MB, FRCS§

doi: 10.1213/01.ANE.0000130000.15786.82
CARDIOVASCULAR ANESTHESIA: Society of Cardiovascular Anesthesiologists: Case Report

Pulmonary thromboendarterectomy, the most common surgical treatment of chronic thromboembolic pulmonary hypertension, is being performed with increasing frequency throughout the world. Massive pulmonary hemorrhage is a potentially fatal complication of this procedure. In this report of three such cases, the diagnosis, clinical course, and possible treatments are discussed. Anesthesiologists involved in the care of patients receiving pulmonary thromboendarterectomy must be aware of the possibility of thiscomplication, as well as the various techniques available for its treatment.

IMPLICATIONS: Massive pulmonary hemorrhage is a potentially devastating complication of pulmonary thromboendarterectomy. Anesthesiologists involved in pulmonary artery surgery must be prepared to treat this complication with a variety of techniques.

Departments of *Anesthesiology and †Cardiac Anesthesiology, ‡Division of Pulmonary Medicine, and §Department of Surgery, Division of Cardiothoracic Surgery, University of California-San Diego Medical Center, La Jolla, California

Accepted for publication April 5, 2004.

Address correspondence and reprint requests to Gerard R. Manecke Jr, MD, Department of Anesthesiology, Thornton Hospital, 9300 Campus Point Dr., La Jolla, CA 92037–7770. Address e-mail to gmanecke@ucsd.edu.

© 2004 International Anesthesia Research Society