1Vimal Chacko Mondy,1Anoop A
Hemoptysis is a rare but potentially lethal complication in patients with congenital heart disease (CHD). Hemoptysis in the setting of CHD can arise from a distinct set of causes which are seldom seen outside this cohort. The aims and objectives of this study were to:
1. To evaluate the various CHD which present with hemoptysis and identify the underlying source of hemoptysis
2. To study the role of interventional radiology in management of hemoptysis in patients with CHD
Material(s) and Method(s):
This was a retrospective single-center study. Consecutive patients with CHD (n=42) who presented with hemoptysis were included in the study. The clinical details were obtained from hospital records and pre-procedural and interventional imaging from PACS. The underlying CHD and the source of hemoptysis were evaluated as well as management of these patients including interventional radiology procedures.
The most common source of hemoptysis were major aortopulmonary collaterals (n=17; 30%) in patients with Tetrology of Fallot and Ventricular septal defect with pulmonary atresia. The most common interventional procedure done was embolization of major aortopulmonary collaterals (n=16; 40%). The other procedures included embolization of pulmonary AVMs (n=2; 5%) and anomalous systemic arterial supply (n=4; 9%). Minor hemoptysis was managed conservatively (n=10; 24%) and some required surgical correction of the underlying cardiac condition (n=10; 24%).
Hemoptysis in the setting of CHD can occur from numerous different sources which are distinct from those seen in the general population. Endovascular management plays a pivotal role in the acute setting for control of hemoptysis as well as in preparing the patient for definitive surgery.