Tamada Naoki, Nakayama Kazuhiko, Shinkura Yuto, Yanaka Kenichi, Katayama Naoto, Okada Takuya, Yamaguchi Masato, Matsumoto Kensuke, Tanaka Hidekazu, Shinke Toshiro, Emoto Noriaki, Hirata Ken-Ichi
Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan.
Department of Radiology, Kobe University Graduate School of Medicine, Japan.
Intern Med. 2017 Dec 15;56(24):3299-3304. doi: 10.2169/internalmedicine.9071-17. Epub 2017 Oct 11.
The patient was a 19-year-old woman who was diagnosed with patent ductus arteriosus complicating Eisenmenger syndrome at a previous medical institution. She was referred to our hospital and arranged for lung transplantation. She developed hemoptysis after the introduction of i.v. epoprostenol, which was administered as a bridging treatment while the patient awaited lung transplantation. She continued to suffer from recurrent hemoptysis, even after switching from i.v. epoprostenol to i.v. treprostinil. Angiography of the systemic and pulmonary arteries revealed the vessel responsible for the recurrent hemoptysis and pulmonary artery embolization was successfully performed. It is essential to identify the culprit vessel and physicians must not hesitate in performing embolization when patients develop lethal hemoptysis.
该患者为一名19岁女性,此前在其他医疗机构被诊断为动脉导管未闭合并艾森曼格综合征。她被转诊至我院并安排进行肺移植。在等待肺移植期间,作为过渡治疗,患者开始静脉注射依前列醇后出现咯血。即使从静脉注射依前列醇改为静脉注射曲前列尼尔,她仍反复咯血。体动脉和肺动脉造影显示了导致反复咯血的血管,并成功实施了肺动脉栓塞术。确定出血责任血管至关重要,当患者出现致命性咯血时,医生必须毫不犹豫地进行栓塞治疗。