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Bronchovenous Fistula During Adult Cardiac Surgery: A Case Report
Kosuke Saita1, Taro Kariya1, Mariko Ezaka2
1From the Departments of Anesthesia and Pain Relief Center, The University of Tokyo Hospital, Tokyo, Japan.
A&A Practice
|October 8, 2020
Summary
Bronchovenous fistula (BVF) is a rare, life-threatening complication of cardiac surgery. Early diagnosis via transesophageal echocardiography and hemoglobin measurement aided in managing this case.
Area of Science:
- Cardiology
- Thoracic Surgery
- Critical Care Medicine
Background:
- Bronchovenous fistula (BVF) is a rare but serious complication following adult cardiac surgery.
- High airway pressure due to restrictive pulmonary pathology can exacerbate BVF.
Observation:
- A 75-year-old woman developed BVF during cardiac surgery with significant pleural and pericardial adhesions.
- The patient required high airway pressure ventilation due to underlying restrictive pulmonary disease.
Findings:
- Transesophageal echocardiography and hemoglobin monitoring facilitated prompt BVF diagnosis.
- Surgical intervention involving transection of the affected pulmonary vein successfully controlled the fistula.
Implications:
- Cannulation site injury is a potential risk factor for developing BVF.
- Careful management of ventilation and cannulation is crucial in preventing BVF post-cardiac surgery.
