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Catastrophic haemoptysis in the Fontan circulation – a novel surgical approach to denude the culprit bleeding vessels

Published online by Cambridge University Press:  25 February 2011

David E. Black ,
Gruschen R. Veldtman ,
Timothy Bryant ,
John Miller  and
Marcus Haw
David E. Black
Affiliation:
Department of Adult Congenital Heart disease and Interventional Radiology, Southampton University Hospital, Southampton, United Kingdom
Gruschen R. Veldtman*
Affiliation:
Department of Adult Congenital Heart disease and Interventional Radiology, Southampton University Hospital, Southampton, United Kingdom
Timothy Bryant
Affiliation:
Department of Adult Congenital Heart disease and Interventional Radiology, Southampton University Hospital, Southampton, United Kingdom
John Miller
Affiliation:
Department of Adult Congenital Heart disease and Interventional Radiology, Southampton University Hospital, Southampton, United Kingdom
Marcus Haw
Affiliation:
Department of Adult Congenital Heart disease and Interventional Radiology, Southampton University Hospital, Southampton, United Kingdom
*
Correspondence to: Dr G. R. Veldtman, Department of Adult Congenital Heart disease and Interventional Radiology, Southampton University Hospital, Southampton, United Kingdom. Tel: 02380 79 6055; Fax: 02380 79 4523; E-mail: gruschen.veldtman@suht.swest.nhs.uk
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Abstract

We describe the case of a young man aged 19 years with a double inlet left ventricle associated with transposition of the great arteries, and a mechanical aortic valve requiring anticoagulation, who presented with massive haemoptysis. At cardiac catheterisation, there were multiple feeder vessels to a bleeding leash surrounding and communicating with his left main bronchus. Despite occlusion of the larger feeder vessels, he continued to have massive haemoptysis. We describe a novel surgical strategy of denuding the peribronchial vessels through a left lateral thoracotomy. This successfully stopped his bleeding.

Keywords

Fontansingle ventriclehaemoptysisarterio-pulmonary collateralscongenital cardiac disease surgery
Type
Brief Reports
Information
Cardiology in the Young , Volume 21 , Issue 4 , 12 July 2011 , pp. 462 - 464
Copyright
Copyright © Cambridge University Press 2011

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