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Intraoperative massive pulmonary embolism during coronary artery bypass grafting

Martin Simek1, Petr Nemec, Mojmír Cermák

  • 1Department of Cardiac Surgery, University Hospital Olomouc and Palacky University School of Medicine, I.P. Pavlova 6, 775 20 Olomouc, Czech Republic. martin.simek@c-mail.cz

Interactive Cardiovascular and Thoracic Surgery
|August 3, 2007
PubMed

Insights

A massive pulmonary embolism during coronary artery bypass grafting was successfully treated with open pulmonary embolectomy. The patient recovered well, remaining free of angina and pulmonary hypertension at six months.

Area of Science:

  • Cardiovascular Surgery
  • Pulmonary Medicine
  • Vascular Surgery

Background:

  • Coronary artery bypass grafting (CABG) is a common cardiac surgery.
  • Massive pulmonary embolism (PE) is a rare but life-threatening complication during or after cardiac surgery.
  • Intraoperative PE can significantly increase surgical risk and mortality.

Purpose of the Study:

  • To report a case of massive intraoperative pulmonary embolism during CABG.
  • To describe the successful surgical management of this critical event.
  • To highlight the feasibility of open pulmonary embolectomy on a beating heart.

Main Methods:

  • A 66-year-old female underwent elective CABG.
  • Massive pulmonary embolism was diagnosed intraoperatively after cardiopulmonary bypass.
  • Open pulmonary embolectomy was performed on the beating heart, extracting a large venous embolus.
  • Postoperative investigations were conducted to identify the source of the embolus.

Main Results:

  • A 25-cm venous embolus was successfully removed from the pulmonary artery.
  • The patient tolerated the embolectomy procedure well.
  • The source of the pulmonary embolism was not identified.
  • At 6-month follow-up, the patient was asymptomatic with no signs of pulmonary hypertension.

Conclusions:

  • Open pulmonary embolectomy on a beating heart is an effective treatment for massive intraoperative PE during CABG.
  • Prompt surgical intervention can lead to favorable outcomes in selected cases.
  • Further investigation may be warranted to elucidate the source of venous emboli in similar intraoperative events.

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