• Roberta Russo, Alessandro Calzolari, Valentina Salice, Camilla Micieli, Claudia Castiglioni, Mattia Gomarasca, Federico Mondin, SalihovicBedrana MoroBMSC Rianimazione e Anestesia ASST Ovest Milanese, Legnano, Italy., Francesca Orsenigo, Davide Negroni, Carmelo Migliorisi, Matteo Lucchelli, and Giovanni Mistraletti.
• Università degli Studi di Milano, Dipartimento di Fisiopatologia medico-chirurgica e dei trapianti, Milan, Italy; SC Rianimazione e Anestesia ASST Ovest Milanese, Legnano, Italy.
• J. Cardiothorac. Vasc. Anesth. 2024 Oct 12.

AbstractThis article discusses a pulmonary artery pseudoaneurysm (PAP) formation following pulmonary artery catheter (PAC) placement for cardiac surgery. The patient, an 82-year-old female with a history of hypertension and chronic heart failure, underwent elective mitral and tricuspid valve surgery. After surgery, bleeding was observed in the endotracheal tube, indicating a potential complication. Fiberoptic bronchoscopy revealed bleeding mainly in the right bronchus. Subsequent computed tomography pulmonary angiogram (CTPA) confirmed the presence of a small pseudoaneurysm in a branch of the pulmonary artery. Prompt collaboration between anesthesiologists, cardiac surgeons, and interventional radiologists led to the successful embolization of the pseudoaneurysm with a minimally invasive approach by using the PAC as a guide catheter to reach the PAP. The article outlines the potential causes of PAP formation, clinical presentation, and management strategies. While conservative, surgical, and interventional approaches are discussed, the preferred treatment is coil embolization due to its effectiveness and minimal invasiveness. The authors emphasize the importance of rapid diagnosis, multidisciplinary collaboration, and the feasibility of using the pulmonary artery route for embolization to rapidly reach the lesion to stabilize. Overall, the case demonstrates the successful resolution of a life-threatening complication through timely intervention and coordinated teamwork.Copyright © 2024 Elsevier Inc. All rights reserved.

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