The aneurysmal sac is formed only by compressed lung parenchyma. This leaves these aneurysms prone to rupture since they are inherently unstable. Due to its high mortality the diagnosis of an PAFA after an initial bleeding is essential. Radiologic findings are well-defined, persistent, pulmonary nodules or masses adjacent to the catheter tip. The method of choice in diagnosing PAFA's has been said to be contrast enhanced CT-scans, especially in patients with pulmonary hypertension.
Pulmonary angiography is the second diagnostic tool.
Position the patient with the affected lung dependent to prevent soiling of the contralateral lung. As soon as the patient is stable enough, diagnosis should be made and embolisation of the branch of the pulmonary artery should be attempted, using stainless steel wire coils. Pulmonary bleeding after restoration of spontaneous circulation after CPB should be an early warning sign. Resuming CPB and exploration of the surgical field may be necessary. To prevent every case of PA-catheter related PAFA probabely is not possible.