CATHETER-INDUCED PULMONARY-ARTERY HEMORRHAGE RESULTING FROM A PNEUMOTHORAX

We present a case of pulmonary artery perforation in a patient who dev eloped a pneumothorax after cardiac surgery. In the process of inserti ng a chest tube the patient became tachypnoeic, and developed haemopty sis. The trachea was intubated, and right bronchial intubation was per formed with persistent bleeding. The pulmonary artery catheter was gen tly withdrawn and the balloon inflated, with cessation of bleeding. Th e patient was taken to the operating room, a bronchial blocker was pla ced in the right lower lobe bronchi, and the pulmonary artery catheter was removed. The bronchial blocker was removed the following day with no bleeding. The aetiology of perforation was secondary to the pneumo thorax, which caused a shift of the mediastinum to the right, elevated pulmonary artery pressures, and the distal migration of the catheter through the pulmonary artery. It is recommended that treatment include tracheal intubation, inflation of the pulmonary artery catheter ballo on, and the placement of a right lower lobe bronchial blocker.