Bédard Elisabeth, Lopez Stéfane, Perron Jean, Houde Christine, Couture Christian, Vaillancourt Rosaire, Côté Jean-Marc, Delisle George, LeBlanc Marie-Hélène, Chetaille Philippe, Lamarre André, Rodés-Cabau Josep
Department of Cardiology, Quebec Heart and Lung Institute, Laval Hospital, Laval, Quebec, Canada.
Can J Cardiol. 2008 Feb;24(2):145-7. doi: 10.1016/s0828-282x(08)70572-5.
Two cases of life-threatening recurrent hemoptysis occurring 10 years after a Fontan operation are presented. Bleeding from aortopulmonary collateral vessels was responsible for this complication in both cases, and the importance of systematic selective angiography of all potential origins of such abnormal vessels, including those arising from the abdominal aorta, is highlighted. Although coil embolization of aortopulmonary collateral vessels is usually definitive, pulmonary lobectomy may be necessary. The present report demonstrates, for the first time, that rescue extracorporeal membrane oxygenation support can be used as a bridge to surgery in case of severe uncontrollable hemoptysis in such cases.
本文报告了两例在Fontan手术10年后发生危及生命的复发性咯血病例。两例病例中，主肺动脉侧支血管出血均导致了这一并发症，强调了对所有此类异常血管的潜在起源进行系统选择性血管造影的重要性，包括那些起源于腹主动脉的血管。虽然主肺动脉侧支血管的弹簧圈栓塞通常是决定性的，但可能需要进行肺叶切除术。本报告首次证明，在这类病例中出现严重无法控制的咯血时，挽救性体外膜肺氧合支持可作为手术的桥梁。
