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Undertaking a pulmonary lobectomy in a virgin chest is recognized as a relatively straightforward operation with acceptably low rates of mortality and morbidity. Redo thoracotomy, particularly in the context of completion lobectomy, represents a more challenging entity. In this situation careful dissection is paramount due to the likelihood of encountering pleuro-parenchymal adhesions, structural architectural changes and loss of tissue planes. These conditions are likely to be even more hazardous if the patient has undergone chemoradiotherapy. The increased risks of bleeding and air leak, as well as the increased operative time, means that redo surgery is usually performed via an open approach, and not via video assisted thoracoscopic surgery (VATS). We describe a case of redo thoracotomy for completion lobectomy where an iatrogenic injury to the pulmonary artery led to signi icant haemorrhage. The potential need for cardiopulmonary bypass was avoided as the situation was controlled by Foley catheter balloon tamponade. Abstract

Foley catheter balloon tamponade as a method of controlling iatrogenic pulmonary artery bleeding in redo thoracic surgery