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Query: UMLS:C0019079 (hemoptysis)
 6,129 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In over 3500 consecutive open heart procedures using Swan-Ganz catheterization at our institution, we have experienced three major pulmonary artery injuries secondary to this procedure. Pulmonary artery hemorrhage is a rare but frequently fatal complication and a mortality rate as high as fifty percent has been reported. In two of these cases, major retraction of the heart was needed for adequate exposure of the cardiac pathology. The Swan-Ganz catheter inadvertently was advanced into the wedge position for prolonged intervals of time, and periodic overdistention of the balloon occurred. The third case occurred in the cardiac catheterization laboratory. The need for aggressive surgical approach has been demonstrated. The authors have recommended steps to be taken when massive hemoptysis occurs and Swan-Ganz catheter perforation of the pulmonary artery is suspected. Re-evaluation of the "routine" use of the Swan-Ganz catheter may be necessary and overutilization may be a distinct possibility. When the use of this catheter is deemed appropriate, a more exact positioning of the distal portion of the catheter is mandatory if pulmonary artery perforation is to be avoided.
J Cardiovasc Surg (Torino)
PMID:Swan-Ganz catheter induced pulmonary hemorrhage. 366 78

We report on two young patients with unusual airway foreign bodies: blowgun darts. These homemade darts are constructed with yarn, thread, and a common pin. Because only the pin is radiopaque, and because the child may be reluctant to disclose the nature of the foreign body, the bronchoscopist may encounter unexpected difficulty in extracting the dart. A radiograph showing a pin head down in the trachea or bronchus, coughing (especially with hemoptysis) in excess of that expected from just an aspirated pin, and a child hesitant to divulge the full history suggest blowgun dart aspiration.
J Thorac Cardiovasc Surg 1986 Jun
PMID:Blowgun dart aspiration. 371 43

Aneurysm of the left pulmonary artery developed in two patients with tetralogy of Fallot at the site of a Potts' shunt. Although such a complication is known we could not find any previously reported case of successful surgical treatment in the literature. Cardiac catheterization and angiography provided the definitive diagnosis. One patient refused surgical intervention but later presented with fatal rupture and massive hemoptysis. Closure of the Potts' shunt, angioplastic repair of the pulmonary artery aneurysm and total correction of tetralogy of Fallot were successfully accomplished using cardiopulmonary bypass and cardioplegic arrest. Aneurysm should be suspected whenever a mediastinal mass appears in patients with a previous systemic-pulmonary artery shunt.
J Cardiovasc Surg (Torino)
PMID:Aneurysm of the pulmonary artery. Rare long term complication of central aorto-pulmonary shunts for congenital heart disease. Report of two cases with review of the literature. 394 86

Thirty-three patients (28 female and five male) from 17 to 70 years of age (mean age 48 years) underwent excision of left atrial myxomas between 1957 and 1981 at The Cleveland Clinic Foundation. Twenty-four patients presented with congestive heart failure, three with tachyarrhythmias, two with syncope, and one each with angina, peripheral embolization, hemoptysis, and recurrent pleural effusions. Symptoms were present from 1 to 72 months before operation (mean 11.2 months). Thirty-one tumors originated from the atrial septum and two from the mitral valve anulus. Twenty-nine tumors were pedunculated, and four were sessile; they weighed from 20 to 112 gm (mean 57 gm). No right atrial or ventricular tumors were identified. The myxomas were successfully removed in all patients, either by shaving them from the atrial septum (n = 17) or by excising a portion of normal atrial septum with the tumor (n = 16). One death (3.0%) occurred 8 days after operation as a result of multiple tumor emboli to the coronary circulation. Follow-up is current and complete in all cases (range 1 to 25 years, mean 6.7 years). Twenty-eight patients are in New York Heart Association Class I, and the remaining four patients are in Class II. No recurrent myxomas have been identified clinically or by echocardiography in any patient. Altogether, 24 patients have been studied by two-dimensional echocardiography up to 20 years after operation (mean 4.0 years). In this series, excellent results were obtained by simple excision of the tumor, with or without a margin of normal atrial septum. Long-term clinical and echocardiographic follow-up is recommended since late recurrence, although rare, has been reported.
J Thorac Cardiovasc Surg 1985 Feb
PMID:The surgical treatment of atrial myxomas. Clinical experience and late results in 33 patients. 396 14

Nineteen cases of unilateral absence of the pulmonary artery (UAPA) were found in a group of 2,960 patients investigated consecutively by cardiac catheterization, angiocardiography, and pulmonary perfusion scintigraphy. The incidence of UAPA was 0,6%. In 8 cases (40%) UAPA was found in isolation, and in 11 cases (60%) it was combined with other congenital heart defects (CHD). In 30% of our patients the diagnosis of UAPA was suggested by clinical symptoms and plain chest X-ray. Pulmonary perfusion scan was made in 2,600 children before catheterization. Though it can provide strong evidence of the diagnosis, this should be confirmed by cardiac catheterization and selective angiography. Eight patients were operated upon. Systemic-pulmonary shunt operations were performed in 6, and ligation of PDA in 2 patients. In one of the latter severe hemoptysis occurred following ligation of the PDA. The pathophysiological and diagnostic aspects of UAPA are discussed.
Thorac Cardiovasc Surg 1982 Jun
PMID:Unilateral absence of pulmonary artery: a report on 19 selected clinical cases. 618 May 9

Massive hemoptysis occurs in 50% to 70% of patients with cystic fibrosis and carries an immediate mortality of up to 32%. Cystic fibrosis is regarded by many as a disease in which thoracic operations are ill-advised. A 21-year-old woman with mild cystic fibrosis presented with unrelenting massive hemoptysis, was not helped by medical management, and underwent a successful left upper lobectomy. We suggest that thoracotomy does have a role in the management of massive hemoptysis in selected patients with cystic fibrosis. On the basis of our case and all other cases reported in the English literature, we suggest criteria for determining which patients are suitable candidates for emergency thoracotomy.
J Thorac Cardiovasc Surg 1983 Sep
PMID:Emergency lobectomy for massive hemoptysis in cystic fibrosis. 641 98

A 67-year-old man with persistent haemoptysis was found to have primary choriocarcinoma of the lung. Only previous cases were found in the international literature. Hyperprolanuria B would seem to be the most important factor for early diagnosis. The recommended treatment is surgery in accordance with the oncologic criteria for bronchopulmonary cancer.
Scand J Thorac Cardiovasc Surg 1982
PMID:Primary choriocarcinoma of the lung. Presentation of a case and review of the literature. 676 31

The charts of 61 patients treated from 1970 through 1981 were reviewed to determine the clinical outcome after treatment of air embolism from blunt (15 patients) and penetrating (21 gunshot and 25 stabbing) thoracic injuries. The diagnosis of air embolism was confirmed by the presence of air in the coronary arteries (57%), air aspirated from the heart (30%) or major artery (10%), or Doppler findings (3%). All patients were in shock or cardiac arrest, and in 36% of these patients there were early signs of hemoptysis or unexpected arrest after intubation and positive-pressure ventilation. Successful management included (1) early thoracotomy for diagnosis as well as for specific treatment, (2) hilar cross-clamping for control of bronchovenous communication, (3) maintenance of perfusion pressures with fluids, vasopressors, or aortic cross-clamping, and (4) prompt correction of the embolic source, usually a lung resection. The overall survival rate was 44%, which correlated with the mechanism of injury, with associated nonthoracic injuries, and with the occurrence of arrest in a controlled setting. We conclude that (1) air embolism can insidiously occur even in blunt trauma; (2) suspicion should be high with hemoptysis or unexpected arrest; and (3) successful treatment includes immediate thoracotomy for diagnosis, resuscitation, and prompt control of the bronchovenous communication.
J Thorac Cardiovasc Surg 1983 May
PMID:Management of air embolism in blunt and penetrating thoracic trauma. 684 44

Case histories of 123 patients with massive hemoptysis were reviewed. The causes of hemorrhage were active pulmonary tuberculosis (47), bronchiectasis (37), chronic necrotizing pneumonia (11), lung abscess (six), lung cancer (six), bronchovascular fistula (five), primary pulmonary fungal infection (four), and miscellaneous (seven). Conservative management was used in 66 patients, with 21 deaths (31.8%). Surgical management was used in 34 patients, with six deaths (17.6%). Endobronchial iced saline lavage was used in 23 patients, with one death. All patients treated by lavage stopped bleeding, and further therapy, either surgical (five) or medical (18), was given as appropriate. The early control of tracheobronchial hemorrhage by endoscopic means is an effective though transitory holding procedure. The unpredictability of massive hemoptysis is underscored by eight deaths from sudden, engulfing hemorrhage in seemingly stable patients awaiting endoscopy or operation.
J Thorac Cardiovasc Surg 1983 Jan
PMID:Massive hemoptysis. Review of 123 cases. 684 80

Massive hemoptysis (600 ml in 24 hours) results in a mortality of more than 50%. We have performed 74 pulmonary resections in patients with massive hemoptysis in the last 15 years, with a mortality of 13%. The mortality correlated with the rate and the amount of recorded blood loss before the operation. From this experience, we have identified a subgroup of patients with such massive hemoptysis that life was threatened by exsanguination. Twenty-four of our patients lost more than 1,000 ml of blood, at a rate of at least 150 ml an hour, before the pulmonary resection was performed. The bleeding site was always identified by bronchoscopy. All patients were treated by resection of the bleeding lung parenchyma. Several methods were used to avoid the patient's drowning in his own blood during the operation. In five patients, a double-lumen endotracheal tube was used: Two died of suffocation during the procedure and another died of respiratory and liver failure. In four patients, single-lung ventilation with an endotracheal tube in the left main bronchus was used: All four survived. In another 10 patients a bronchial blocker (No. 9 Fogarty balloon venous catheter) was used to stop bleeding. Two patients died of renal failure and gastrointestinal bleeding, respectively, but none had aspiration problems. In five additional patients, a regular endotracheal tube was used: One patient died of massive aspiration. Our experience indicates that bleeding from the left lung and right lower lobe should be controlled by intubation of the left bronchus. Patients with exsanguinating hemoptysis should be treated, when possible, by pulmonary resection. A survival rate of 75% was obtained in our patients.
J Thorac Cardiovasc Surg 1982 Dec
PMID:Exsanguinating hemoptysis. 714 17


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