Foley catheter balloon tamponade as a method of controlling iatrogenic pulmonary artery bleeding in redo thoracic surgery
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Abstract
Background: Pulmonary artery bleeding secondary to iatrogenic injury is a troublesome intraoperative complication. The likelihood of encountering this complication is significantly higher in redo surgery for a number of reasons, including distortion of anatomical structures, adhesions and loss of tissue planes. Significant blood loss, although rare, remains a concern, and can occasionally be life-threatening. When significant bleeding from the pulmonary artery occurs, it can be a challenging situation to manage.
Case Report: A 65 year old female was undergoing redo thoracic surgery in the setting of a completion lobectomy for biopsy-proven primary adenocarcinoma of the lung. Iatrogenic injury to the pulmonary artery resulted in significant bleeding that could not be managed by gaining proximal control due to dense adhesions. The novel decision to utilize a Foley catheter for balloon tamponade was taken, in order to provide sufficient haemostasis for definitive surgical repair of the defect to be undertaken
Conclusion: The increased technical difficulties of redo thoracic surgery are well recognised. We describe the first case of Foley catheter balloon tamponade being utilized in the context of iatrogenic pulmonary artery bleeding during thoracic surgery.
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Nwaejike N, Elbur E, Malagon I, Dodman N, Hewitt K, et al. Is there a role for the high-risk multidisciplinary team meeting in thoracic surgery? Interact Cardiovasc Thorac Surg. 2016; 22: 397-400. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/26810916
Lung cancer clinical outcomes publication 2016. Royal College of Physicians & Society for Cardiothoracic Surgery in Great Britain & Ireland.
Agostini P, Cieslik H, Rathinam S, Bishay E, Kalkat MS, et al. Postoperative pulmonary complications following thoracic surgery: are there any modifiable risk factors? Thorax. 2010; 65: 815-818. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/20805178
Lim E, Baldwin D, Beckles M, Duffy J, Entwisle J, et al. Guidelines on the radical management of patients with lung cancer. British Thoracic Society. 2010. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/20940263
Omasa M, Date H, Takamochi K, Suzuki K, Miyata Y, et al. Completion lobectomy after radical segmentectomy for pulmonary malignancies. Asian Cardiovasc Thorac Ann. 2016; 24: 450–454. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/27207503
Taylor H, Williams E. Arteriovenous fistula following disk surgery. Br J Surgery. 1962; 50: 47-50. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/13919962 v
Elmoghrabi A, Mohamed M, Eggers A, Parmar N, McCann M. More than just a urinary catheter - Haemorrhage control by using a Foley catheter in a penetrating aortic root injury. Trauma Case Rep. 2016; 5: 13-17. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/29942849
Feliciano DV, Burch JM, Mattox KL, Bitondo CG, Fields G. Balloon catheter tamponade in cardiovascular wounds. Am J Surg. 1990; 160: 583-587. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/2252117
Weppner J. Improved mortality from penetrating neck and maxillofacial trauma using Foley catheter balloon tamponade in combat. J Trauma Acute Care Surg. 2013; 75: 220-224. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23823611
Navsaria P, Thoma M, Nicol A. Foley catheter balloon tamponade for life-threatening hemorrhage in penetrating neck trauma. World J Surg. 2006; 30:1265-1268. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/16830215