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[Successful direct embolectomy for acute massive pulmonary thromboembolism]
1Department of Cardiovascular Surgery, Kashiwa Hospital, Tokyo Jikei University School of Medicine, Chiba, Japan.
[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai
|October 1, 1996
Summary
Surgical embolectomy effectively removed a large pulmonary embolism in a patient unresponsive to anticoagulation therapy. This case highlights surgery as a vital option for severe pulmonary thromboembolism resistant to medical treatment.
Area of Science:
- Cardiovascular Surgery
- Pulmonary Medicine
- Vascular Surgery
Background:
- Pulmonary embolism (PE) is a serious condition often resulting from deep vein thrombosis (DVT).
- Management typically involves anticoagulation, but some cases progress despite therapy.
Observation:
- A 35-year-old female patient developed severe pulmonary embolism following lower extremity venous thromboembolism.
- Despite anticoagulation, her condition deteriorated to Green-field's Class IV, indicating hemodynamic compromise.
Findings:
- An urgent surgical pulmonary embolectomy was performed under moderate hypothermic cardiopulmonary bypass.
- An 18-gram clot was directly removed from the pulmonary artery, with additional fragments cleared using specialized instruments.
Implications:
- The patient experienced efficient symptom recovery post-surgery.
- This case supports surgical intervention for acute pulmonary embolism refractory to anticoagulation, despite a lack of established guidelines.