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Surgical Treatment in a High-Risk Pulmonary Embolism: Case Report
Horatiu Moldovan1,2, Andra-Madalina Sibisan2, Robert Tiganasu2
1Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 014461 Bucharest, Romania.
Medicina (Kaunas, Lithuania)
|August 6, 2021
Summary
A postpartum woman with high-risk pulmonary embolism underwent emergency open pulmonary embolectomy due to hemodynamic instability. This case supports the procedure for critically ill patients with clinical diagnosis.
Area of Science:
- Cardiology
- Vascular Surgery
- Critical Care Medicine
Background:
- Pulmonary embolism (PE) is a significant risk following Cesarean section.
- Risk stratification for PE is crucial for timely intervention.
Observation:
- A 35-year-old woman developed deep vein thrombosis (DVT) and subsequent high-risk PE post-Cesarean section.
- Anticoagulant therapy was ineffective, leading to hemodynamic instability and critical deterioration.
- CT scan revealed a large embolus extending into the right atrium and through the tricuspid valve.
Findings:
- Emergency open pulmonary embolectomy was performed using a modified Trendelenburg procedure under cardiopulmonary bypass.
- The patient was hemodynamically unstable, severely desaturated, bradycardic, hypotensive, and unconscious prior to the procedure.
Implications:
- This case highlights the efficacy of emergency open pulmonary embolectomy in hemodynamically unstable patients with PE.
- Clinical diagnosis and prompt surgical intervention can be life-saving in severe PE cases.
- Supports the use of open embolectomy as a viable option for critical PE patients.
