Intraoperative management of severe endobronchial hemorrhage

Endobronchial hemorrhage due to pulmonary artery perforation by a Swan-Ganz catheter developed during coronary artery bypass grafting while weaning from cardiopulmonary bypass. After reinstitution of cardio-pulmonary bypass with pulmonary artery venting, bleeding was localized to the right lower lobe bronchus using fiberoptic bronchoscopy. A Fogarty embolectomy catheter was inflated in the bronchus to tamponade successfully only the right lower lobe. This case illustrates a method of distal bronchial blockade for maximal retention of pulmonary function and avoidance of pulmonary resection.