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Repair of acute mediastinoscopic injury to the pulmonary artery using an intravascular approach and deep hypothermic circulatory arrest

^a Department of Cardiothoracic Surgery and Anesthesiology, Karolinska Institutet at Huddinge University Hospital, SE-141 86 Stockholm, Sweden
^b Department of Otorhinolaryngology, Karolinska Institutet at Huddinge University Hospital, Stockholm, Sweden

^* Corresponding author. Tel.: +46-8-585-867-45; fax: +46-8-585-867-40
anders.albage{at}hs.se

A potentially serious but rare complication of mediastinoscopy procedures is acute damage to any of the great vessels in the region of the distal trachea and carina. We report a case of serious hemorrhage from a mediastinoscopic biopsy-injury to the posterior aspects of the right pulmonary artery (RPA), which required sternotomy, cardiopulmonary bypass, division and retraction of the ascending aorta, incision of the RPA, intermittent deep hypothermic circulatory arrest, and suturing from the inside of the RPA for a successful repair.

Key Words: Mediastinoscopy; Hemorrhage; Pulmonary artery; Deep hypothermic circulatory arrest