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

Eight patients in whom new respiratory symptoms developed following pulmonary resection have been evaluated. The bronchial stumps in all of these patients had been closed with Tevdec suture material. The total number of pulmonary resections using Tevdec suture from January, 1971, to January, 1980, was 180, yielding an incidence of the complication of 4.4%. No patient had empyema or bronchopleural fistula. Symptoms included nonproductive cough (eight patients), hemoptysis (five patients), wheezing (two patients), and coughing up suture material (two patients). The underlying disease necessitating pulmonary resection was carcinoma in five patients, carcinoid adenoma in one patient, tuberculosis in one patient, and bronchiectasis in one patient. The median time interval between resection and development of respiratory symptoms was 18 months, with a range of 8 to 57 months. The chest roentgenograms showed no change from earlier postoperative films. Bronchoscopy under general anesthesia was performed in all eight patients. Granulation tissue around loosened Tevdec sutures was present in all patients so examined. No residual tumor or specific infection was identified. Immediate and sustained relief of symptoms was obtained in seven of eight patients by removal of the loosened sutures. One patient has had recurrence of minor hemoptysis 18 months following suture removal but has refused further endoscopy. Stainless steel staples have been used for bronchial stump closure in over 100 pulmonary resections since 1977 and no such complications have been seen.
J Thorac Cardiovasc Surg 1981 Apr
PMID:Bronchoscopic diagnosis and treatment of bronchial stump suture granulomas. 720 61

Six cases of pulmonary artery perforation associated with the use of Swan-Ganz catheters are reviewed. Risk factors included pulmonary hypertension, anticoagulation, and hypothermia. The mechanisms leading to perforation were clarified by the use of postmortem studies employing isolated whole lung preparations. These studies revealed that perforation results from (1) tip perforation of vasculature, (2) eccentric balloon configuration propelling the balloon through the vessel wall, and (3) balloon inflation disrupting the pulmonary artery (mean intraballoon pressure 250 mm Hg). Early clinical symptoms include hemoptysis of bright red blood and/or hypotension. Immediate evaluation may necessitate examination with a fiberoptic bronchoscope and "wedge" angiogram. If massive hemoptysis occurs, isolation of the unaffected lung by endobronchial intubation is mandatory. Pneumonectomy or lobectomy may be required. Revised guidelines for catheter insertion and pulmonary capillary wedge pressure (PCWP) measurements are presented. Finally, consideration is given to redesigning the pulmonary artery flow-guided catheter, particularly for use in patients undergoing cardiac operations with systemic anticoagulation. Modifications should be directed at (1) softer catheter tip with temperature-insensitive body, (2) low-pressure balloon, and (3) balloon pressure relief valve.
J Thorac Cardiovasc Surg 1981 Jul
PMID:Catheter-induced pulmonary artery perforation. Mechanisms, management, and modifications. 724 32

In the past 2 years, eight patients have had repair of coarctation of the aorta or interrupted aortic arch along with an intracardiac procedure performed through a simple midsternotomy. Five underwent total repair and three had palliation for the intracardiac lesion. Four patients did well (including one who required a resection for recoarctation), two died intraoperatively, and two died postoperatively (11 and 21 days), one of them from clostridial sepsis and the other from cerebral anoxia that followed a cardiac arrest precipitated by a massive hemoptysis. We found that with this approach the aortic obstruction could be readily relieved and the intracardiac procedure carried out. Since the majority of these patients have compromised hemodynamic status, the ease of instituting immediate bypass, avoidance of a separate incision, and feasibility of total repair are major advantages.
J Thorac Cardiovasc Surg 1981 Jul
PMID:Transmediastinal repair of complex coarctation and interrupted aortic arch. 724 40

A case with severe haemoptysis nearly three weeks after a chest trauma is presented. Aortography revealed rupture of the aorta below the origin of the left subclavian artery. The rupture was caused by a fractured rib which also caused a tear in the lower lobe of the left lung. Aortic haemorrhage had dissected into the lung, causing a haematoma and finally resulting in a severe haemoptysis.
Scand J Thorac Cardiovasc Surg 1981
PMID:Haemoptysis associated with traumatic rupture of the thoracic aorta. 733 93

We reviewed 69 patients with documented carcinoid tumors, 67 of whom had resectable disease. Operations included nine pneumonectomies, 31 lobectomies, 12 bilobectomies, five segmental resections, and 10 sleeve resections. Follow-up on 65 patients reveals 40 surviving beyond 5 years and 13 beyond 20 years since resection. There were no operative deaths and only one recurrence (local) that was subsequently successfully resected. Twenty patients had had recurrent unifocal pneumonitis or hemoptysis for up to 5 years prior to diagnosis. Two patients had the carcinoid syndrome. Biopsy was performed on 23 tumors and resulted in "moderate-to-severe" hemorrhage in six cases. Lymphatic spread was present in seven cases. All seven are alive and free of disease, six of whom have been followed from 5 to 24 years. Diseased resection margins were present in two cases, with both surviving 20 years after resection. All 10 sleeve resections were performed more than 5 years ago. We conclude that carcinoid tumors carry a favorable prognosis upon resection, even when intrathoracic lymphatic metastases are present and are resected. Lung-sparing resections including sleeve resections should be utilized. Recurrent pneumonia or hemoptysis or both requires diligent investigation. Biopsy of the tumors may be performed with care.
J Thorac Cardiovasc Surg 1980 Apr
PMID:Bronchial carcinoid tumors: twenty years' experience. 735 32

The development of the flow-directed balloon catheter has greatly facilitated the monitoring of seriously ill patients. As the use of this catheter has increased, so have the reports of complications, the most serious of which is fatal pulmonary hemorrhage. Eleven cases of pulmonary hemorrhage have been described in the literature, and we have reported an additional case. The presenting symptom in 10 patients was hemoptysis, and the course of eight of these patients was rapidly fatal. The most frequent significant finding at autopsy was a laceration of a small peripheral pulmonary artery, usually at a bifurcation. The pathogenesis, prophylaxis, and management of this complication are discussed.
J Thorac Cardiovasc Surg 1980 Sep
PMID:Pulmonary hemorrhage associated with balloon flotation catheters: report of a case and review of the literature. 741 51

Two patients referred to Ochsner Foundation Hospital after ventricular aneurysm repair had the delayed pulmonary complications of massive hemoptysis and bronchiectasis. Only three cases of infected ventricular aneurysm repair have been reported previously. The felt buttress used in aneurysm repair may be the seat of indolent infection or it may erode into pulmonary tissue with secondary infection. For anatomic reasons the lingular segment of the lung appears to be at increased risk of involvement. Symptoms led to the correct diagnosis in one case at 7 months and in the other at 3 years after the original operation. Infection may be prevented by appropriate measures. However, should such a catastrophe occur, aggressive surgical therapy with removal of all foreign material is mandatory.
J Thorac Cardiovasc Surg 1981 Mar
PMID:Delayed pulmonary complications of ventricular aneurysm repair. Report of two cases and review of the literature. 746 2

This retrospective study of elective pneumonectomy for complicated inflammatory lung disease was done to define modern-day mortality and morbidity. One hundred twenty-four patients received elective pneumonectomy. Patient ages ranged from 6 months to 71 years. Past, recurrent, or new pulmonary tuberculosis was present in 107 patients (86.3%). Clinical presentation involved recurrent infections or severe suppurative sequelae (abscess, empyema). Forty-seven patients had chronic hemoptysis and 25 patients had past or recent massive hemoptysis (> 600 ml of hemoptysis fluid within 24 hours). Nutritional deficiencies were common. One hundred six patients (85.5%) had end-stage destroyed lungs. Evaluative bronchoscopy showed inflammatory endobronchial changes in 106 patients (85.5%), bronchial strictures in 4, and indolent endobronchial tumor in 2. Lung separation was by double-lumen tube in 96 patients, single lung-single tube in 6, bronchus blocker in 6, and prone posture in 9. Extrapleural pneumonectomy was done in 83 patients (66.9%). Fifty-seven of these procedures were left sided and 26 were right sided. Standard transpleural pneumonectomy was done in 41 patients (33.1%): 30 left sided and 11 right sided. Nine pneumonectomies were conducted with the patient in the prone position. Four patients had completion pneumonectomy. Hospital mortality was three deaths (2.4%). Morbidity included postpneumonectomy empyema in 19 patients (15.3%). Seven postoperative bronchopleural fistulas occurred. Empyema in most patients was managed by open pleural drainage (thoracostoma) and later space closure. Pneumonectomy proved effective therapy with low mortality but postpneumonectomy empyema posed serious morbidity.
J Thorac Cardiovasc Surg 1995 Oct
PMID:Elective pneumonectomy for benign lung disease: modern-day mortality and morbidity. 747 40

Pneumonia in the immunocompromised patient remains a significant cause of morbidity and mortality. These patients are susceptible to a wide variety of organisms, but specific infections tend to occur in well defined settings. The type of infection can be predicted based on the nature and severity of the immune defect, past patient exposures, chemotherapy given, radiographic presentation, and acuteness of illness. New treatments, including growth factors, the oral antifungal agents, and antiviral drugs, such as ganciclovir and acyclovir, have improved management and prognosis in some cases. However, some problems have increased with a significant risk of spontaneous pneumothorax now seen with Pneumocystis carinii infection. Bronchoscopy with bronchoalveolar lavage plays a major role in diagnosis, particularly for P carinii and cytomegalovirus infection. However, open lung biopsy remains essential for diagnosis in some settings. Surgical resection for control of hemoptysis and for removal of residual foci of disease also are an integral part of management of pulmonary fungal infections in the immunosuppressed patient.
Semin Thorac Cardiovasc Surg 1995 Apr
PMID:Pulmonary infection in the immunocompromised patient. 761 59

Myxoma of the right ventricle is of very rare occurrence. An adult male patient presented with Class III dyspnoea and occasional haemoptysis and clinically was suspected to have pulmonary stenosis. Magnetic resonance imaging study revealed presence of myxoma arising from the right-ventricular free wall and prolapsing into the pulmonary artery but not involving the pulmonary valve. The myxoma was excised via right ventriculotomy using cardiopulmonary bypass. The patient had an uneventful recovery. The relevant literature is reviewed.
Thorac Cardiovasc Surg 1994 Aug
PMID:Right-ventricular myxoma presenting as right-ventricular outflow-tract obstruction--case report and review of the literature. 782 65


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