Mitral Stenosis, Massive Pulmonary Hemorrhage, and Emergency Valve Replacement

Abstract

HEMOPTYSIS occurs quite frequently as a consequence of mitral stenosis, but massive, life-threatening pulmonary hemorrhage is distinctly unusual.1 2 3 4 5 6 Oppenheimer and Schwartz3 have termed its occurrence "paroxysmal pulmonary hemorrhage," and Wood4 referred to it as "pulmonary apoplexy." Such hemorrhage has resulted in fatal asphyxia from intrabronchial blood clots on rare occasions.7 , 8 Two cases of closed mitral commissurotomy performed as an emergency because of severe hemoptysis have been reported.9 , 10 In the case presented below, a serious threat of asphyxia was averted by the bronchoscopic removal of blood clots that formed casts of the entire tracheobronchial tree. Such extensive blood-cast formation represents a . . .