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Minimally Invasive Techniques |

The Inadvisability of Thoracoscopic Lung Biopsy on Patients With Pulmonary Hypertension*

Seiki Hasegawa, MD, PhD, FCCP; Noritaka Isowa, MD, PhD; Toru Bando, MD, PhD; Hiromi Wada, MD, PhD, FCCP
Author and Funding Information

*From the Department of Thoracic Surgery, Kyoto University, Kyoto, Japan.

Correspondence to: Seiki Hasegawa, MD, Department of Thoracic Surgery, Kyoto University, 53 Shogoin, Kyoto 606-8507, Japan; e-mail: seikiha@kuhp.kyoto-u.ac.jp



Chest. 2002;122(3):1067-1068. doi:10.1378/chest.122.3.1067
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The use of video-assisted thoracoscopic surgery (VATS) sometimes leads to additional and unnecessary risks compared with thoracotomy. We report a troubling case of VATS lung biopsy in a 43-year-old woman with mild pulmonary hypertension. A progressive elevation of pulmonary artery pressure (PAP) was noted after the commencement of right unilateral ventilation. When the systolic PAP reached 90 mm Hg (390 min after induction of anesthesia), a massive blood discharge through the chest drain occurred. At repeat thoracotomy, continuous blood spouting was seen from > 10 of the surgical sites. It was supposed that the endoscopic staplers were unable to maintain hemostasis with such a high PAP.

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