Successful Treatment for Persistent Air Leaks with an Autologous “Blood Patch” Pleurodesis after the Norwood Procedure

Hideki Tatewaki	Toshihide Nakano	Kazuhiro Hinokiyama
Noriyoshi Ebuoka	Hidekazu Matsumae	Daisuke Machida
Takahiro Shoujima	Jin Ikarashi	Ryuji Tominaga and Hideaki Kado

Department of Cardiovascular Surgery, Fukuoka Children’s Hospital, Fukuoka, Japan, and Department of Cardiovascular Surgery Graduate School of Medical Science, Kyushu University, Fukuoka, Japan）

Persistent massive air leak after pediatric cardiac surgery is a rare and possibly life-threatening complication which is difficult to treat. We report a 3-month-old boy with hypoplastic left heart syndrome that underwent Glenn take-down, suffered from pulmonary hemorrhage during surgery and needed mechanical ventilation with high airway pressure that caused bilateral pneumothorax. After pulmonary hemorrhage improved, pneumothorax with persistent air leaks did not resolve under prolonged chest tubes. This patient underwent an autologous “blood patch” pleurodesis on postoperative day 32. The procedure was repeated a second time 48 h after the application of the first blood patch. After these procedures, air leaks dramatically ceased. The patient was successfully weaned from the ventilator on postoperative day 70. Pleurodesis with an autologous blood patch is a safe and an effective technique for the treatment of persistent air leaks, even for a 3-month-old boy with hypoplastic left heart syndrome.

 

Jpn. J. Cardiovasc. Surg. 43:340-343（2014）

Keywords： hypoplastic left heart syndrome;persistent air leak;autologous blood patch pleurodesis