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Fernandez Gonzalez L, Blanco Mata R, Arriola Meabe J, Galdeano Miranda JM. Percutaneous solution of post-cardiac surgery complications. An Pediatr (Barc) 2023:S2341-2879(23)00098-4. [PMID: 37173276 DOI: 10.1016/j.anpede.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 11/16/2022] [Indexed: 05/15/2023] Open
Affiliation(s)
| | - Roberto Blanco Mata
- Cardiología Intervencionista, Hospital Universitario de Cruces, Baracaldo, Vizcaya, Spain
| | - Josune Arriola Meabe
- Cardiología Intervencionista, Hospital Universitario de Cruces, Baracaldo, Vizcaya, Spain
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An J, Dong Y, Niu H. Application of the 5F JL4 Catheter in Bronchial Artery Embolization With the Opening in the Inferior Wall of the Aortic Arch. Vasc Endovascular Surg 2023; 57:379-385. [PMID: 36597616 DOI: 10.1177/15385744221149910] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND We investigated the efficacy and safety of bronchial artery embolization (BAE) using a 5F JL4 catheter in patients with hemoptysis and a bronchial artery opening in the inferior wall of the aortic arch. METHODS This was a single-center retrospective study. Seventeen patients underwent BAE using 5F JL4. We then evaluated technical success (TS), clinical success (CS), incidence of complications, and hemoptysis recurrence rate (RR). RESULTS The TS rate of microcatheter superselective catheterization and CS rate after surgery were 100%, and the incidence of severe complications and postoperative RR were 17.6%. CONCLUSIONS Bronchial artery embolization for hemoptysis with a BA opening in the inferior wall of the aortic arch using the 5F JL4 catheter could be a safe method. The short- and medium-term results were excellent.
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Affiliation(s)
- Jianli An
- Department of Interventional Treatment, Qinhuangdao Municipal No. 1 Hospital, Qinhuangdao, PR China
| | - Yanchao Dong
- Department of Interventional Treatment, Qinhuangdao Municipal No. 1 Hospital, Qinhuangdao, PR China
| | - Hongtao Niu
- Department of Interventional Treatment, Qinhuangdao Municipal No. 1 Hospital, Qinhuangdao, PR China
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Fernandez Gonzalez L, Blanco Mata R, Arriola Meabe J, Galdeano Miranda JM. Solución percutánea de complicaciones poscirugía cardiaca. An Pediatr (Barc) 2022. [DOI: 10.1016/j.anpedi.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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Avdimiretz N, Glicksman A, Dell S, John P, Moraes TJ. Rare broncho-pulmonary arterial fistula in a healthy 9-year-old girl. BMJ Case Rep 2020; 13:e234865. [PMID: 33004353 PMCID: PMC7534672 DOI: 10.1136/bcr-2020-234865] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2020] [Indexed: 01/16/2023] Open
Abstract
A 9-year-old previously well girl presented with multiple episodes of large volume haemoptysis and right sided consolidation. She continued to have haemoptysis despite intravenous antibiotics. CT chest suggested a right mainstem endobronchial lesion; this was not seen on bronchoscopy where an extensive blood clot was removed. Distal flexible bronchoscopy could not identify the source of bleeding. CT angiogram revealed a broncho-pulmonary arterial fistula, a rare cause of haemoptysis in children. Endovascular embolisation resulted in short-term symptom resolution; however, haemoptysis recurred months later, leading to re-embolisation. This case highlights a stepwise approach to the workup of large volume haemoptysis.
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Affiliation(s)
- Nicholas Avdimiretz
- Pediatric Respirology, Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Amy Glicksman
- Pediatrics, Humber River Hospital, Toronto, Ontario, Canada
| | - Sharon Dell
- Pediatric Respirology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Philip John
- Interventional Radiology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Theo J Moraes
- Pediatric Respirology, Hospital for Sick Children, Toronto, Ontario, Canada
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Bronchial Artery Embolization in Pediatric Pulmonary Hemorrhage: A Single-Center Experience. J Vasc Interv Radiol 2020; 31:1103-1109. [DOI: 10.1016/j.jvir.2019.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 10/16/2019] [Accepted: 11/09/2019] [Indexed: 01/04/2023] Open
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Kuang HY, Li Q, Xiang P, Feng C, Yi QJ, Lu TW. Potential Factors Affected Safety and Efficacy of Transcatheter Plug Closure for Pediatric Hemoptysis with Anomalous Bronchial Arteries. J Interv Cardiol 2019; 2019:5408618. [PMID: 31772535 PMCID: PMC6739801 DOI: 10.1155/2019/5408618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 01/22/2019] [Accepted: 02/04/2019] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To evaluate the safety and efficacy of interventional care in pediatric hemoptysis for anomalous bronchial arteries (BAs) and to identify the potential factors resulting in hemoptysis recurrence. METHODS 20 children complained of hemoptysis were diagnosed with anomalous BAs. All patients received transcatheter plug occlusion in Department of Cardiology, Children's Hospital of Chongqing Medical University. The safety and efficacy were evaluated according to clinical symptoms and images monitoring of enrolled subjects grouped as recurrence group and nonrecurrence group. The potential factors causing hemoptysis recurrence were reviewed and summarized. RESULTS No deaths were recorded in a follow-up. Otherwise, hemoptysis recurrence was found in 8 subjects for 14 times, accounting for about 40%. Compared with nonrecurrence group, it indicated a statistical significance in hemoglobin levels (P=0.049), mycoplasma pneumonia particle assays (MP-PA) titers (P=0.030), and number of anomalous BAs (P=0.020). Meanwhile, 50% recurrent scenarios were associated with a respiratory infection by microbiological assessment before transcatheter plug occlusion. The repeat occlusion was applied for unclosed BAs leading to visual recurrent hemoptysis, the average interval time of which was 5.4 ± 3.6 mon. CONCLUSION The data from this retrospective study have shown that transcatheter plug occlusion is a relatively safe procedure with a low mortality. The number of abnormal BAs has been identified as a highly significant predictor of recurrence, and the role of MP and other potential factors should be verified in a multicenter, larger sample size, and randomized controlled trial.
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Affiliation(s)
- Hong-Yu Kuang
- Department of Cardiology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China
- China International Science and Technology Cooperation Base of Child development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Qiang Li
- Department of Cardiology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China
- China International Science and Technology Cooperation Base of Child development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Ping Xiang
- Department of Cardiology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China
- China International Science and Technology Cooperation Base of Child development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Chuan Feng
- Department of Radiology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - Qi-Jian Yi
- Department of Cardiology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China
- China International Science and Technology Cooperation Base of Child development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Tie-Wei Lu
- Department of Cardiology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China
- China International Science and Technology Cooperation Base of Child development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
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Zaidi SJ, Schweig L, Patel D, Javois A, Akhter J. A novel approach to the diagnosis and treatment of hemoptysis in infants: A case series. Pediatr Pulmonol 2018; 53:1504-1509. [PMID: 30226294 PMCID: PMC7168067 DOI: 10.1002/ppul.24160] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 08/19/2018] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Hemoptysis in children is an uncommon presenting symptom but can be life-threatening if massive. Cardiac catheterization and coil embolization of aorto-pulmonary collateral vessels (APCs) is uncommon in pediatric hemoptysis patients without congenital heart disease. METHODS We present a series of seven infants (≤12 months of age) with hemoptysis, all of whom underwent cardiac catheterization to look for and intervene upon APCs, if found. Only those patients who underwent both bronchoscopy as well as cardiac catheterization from January 1995 to January 2015 were included in this retrospective review. RESULTS Seven patients met inclusion criteria, and three had a history of recurrent hemoptysis. The mean age was 3 months. Four had evidence of bleeding on bronchoscopy. All seven had respiratory distress which necessitated ICU admission; five required mechanical ventilation. Cardiac catheterization showed significant APCs (>2 mm) in six of the seven studied patients, all of which were coil embolized. One patient had no significant APCs and therefore, no embolization. All patients had complete resolution with no recurrences during the 10-20-year outpatient follow-up period. Chest CT scans were not helpful in delineating the site or etiology of bleeding in any patient. CONCLUSIONS APCs should be considered as a differential diagnosis for pulmonary hemorrhage in infants after more common causes have been ruled out.
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Affiliation(s)
- S Javed Zaidi
- Department of Pediatric Cardiology, Advocate Children's Hospital, Oak Lawn, Illinois
| | - Lorene Schweig
- Department of Pediatric Cardiology, Advocate Children's Hospital, Oak Lawn, Illinois
| | - Dhaval Patel
- Department of Pediatric Cardiology, Advocate Children's Hospital, Oak Lawn, Illinois
| | - Alexander Javois
- Department of Pediatric Cardiology, Advocate Children's Hospital, Oak Lawn, Illinois
| | - Javeed Akhter
- Department of Pediatric Pulmonology, Advocate Children's Hospital, Oak Lawn, Illinois
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Vaiman M, Klin B, Rosenfeld N, Abu-Kishk I. Pediatric Pulmonary Hemorrhage vs. Extrapulmonary Bleeding in the Differential Diagnosis of Hemoptysis. Cent Asian J Glob Health 2017; 6:284. [PMID: 29138740 DOI: 10.5195/cajgh.2017.284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Introduction Hemoptysis is an important symptom which causes a major concern, and warrants immediate diagnostic attention. The authors compared a group of patients with pediatric pulmonary hemorrhage with pediatric patients diagnosed with extrapulmonary bleeding focusing on differences in etiology, outcome and differential diagnosis of hemoptysis. Methods We performed the retrospective analysis of medical charts of 134 pediatric patients admitted to the Emergency Department because of pulmonary and extrapulmonary hemorrhage and were diagnosed with suspected hemoptysis or developed hemoptysis (ICD10-CM code R04.2). The cases with pulmonary hemorrhage (Group 1) were compared with cases of extrapulmonary bleeding (Group 2) using the Fisher Exact test or Pearson's χ2 test for categorical variables. The t-test was used to assess differences between continuous variables of the patients in the two groups. Results Bloody cough was the presenting symptom in 73.9% of cases. 30 patients had pulmonary hemorrhage (Group 1), while 104 patients had extrapulmonary bleeding (Group 2). The underlying causes of bleeding in Group 2 included epistaxis, inflammatory diseases of nasopharynx and larynx, foreign bodies, gingivitis, and hypertrophy of adenoids. Mortality rate was 10% in Group 1, whereas Group 2 did not have any mortality outcomes during the observation period. Etiologycal factors were significantly different between hemoptysis and extrapulmonary bleeding in children. Conclusions Our research suggested that pulmonary and extrapulmonary bleeding are two conditions that differ significantly and cannot be unified under one diagnostic code. It is important to differentiate between focal and diffuse cases, and between pulmonary and extrapulmonary hemorrhage due to the diversity of clinical courses and outcomes.
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Affiliation(s)
- Michael Vaiman
- Department of Ear Nose and Throat - Head and Neck Surgery, Assaf Harofeh Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Baruch Klin
- Department of Pediatric Surgery, Assaf Harofeh Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Noa Rosenfeld
- wPediatric Intensive Care Unit, Assaf Harofeh Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Ibrahim Abu-Kishk
- wPediatric Intensive Care Unit, Assaf Harofeh Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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