肺動脈カテーテルによる肺動脈損傷に対する術中血管内治療

Intraoperative Catheter Embolization for Pulmonary Artery Injury Caused by a Pulmonary Artery Catheter

肺動脈カテーテル（PAC）による肺動脈（PA）損傷はきわめてまれであるものの，重篤な合併症の一つである．われわれはPACによる術中PA損傷に対して術中にPA主幹部からのアプローチによる血管内治療を行い，救命しえた2例を経験したので報告する．

We report two cases of intraoperative transcatheter embolization for pulmonary artery injury caused by a pulmonary artery catheter （PAC）. The 1st case who had severe mitral regurgitation and tricuspid regurgitation with giant left and right atrium underwent mitral and tricuspid annuloplasty. The 2nd case woman underwent aortic valve replacement and coronary artery bypass grafting. Sudden massive hemoptysis occurred during weaning from cardiopulmonary bypass in both cases, and pulmonary artery injury due to PAC was diagnosed. Both cases underwent pulmonary arteriography via the main pulmonary artery trunk and transcatheter embolization, and successful hemostasis was obtained. During intraoperative endovascular treatment, an approach via the main pulmonary artery trunk is very useful for diagnosis and treatment.