[An emergent surgical case of acute massive pulmonary embolism supported by antithrombotic percutaneous...

We present an emergent surgical case of massive pulmonary embolism. A 57-year-old male patient was refereed to our medical center for progressive dyspnea. He was intubated because of severe hypoxia. Pulmonary arteriography revealed massive pulmonary embolism. In the catheter laboratory he fell in shock and the heart was arrested, antithrombotic percutaneous cardiopulmonary support (PCPS) was introduced immediately. Emergent thrombectomy was carried out consequently under moderate hypothermic complete cardiopulmonary bypass. Up to 30 x 20 x 10 mm in size fresh clots were removed. Antithrombotic PCPS and IABP were maintained for 168 hours postoperatively. There were no hemorrhagic complication during the support because low dose heparin was administered continuously to keep ACT around 150 sec. He discharged from the hospital two months later and alive in good health. In conclusion, antithrombotic PCPS is very useful to care massive pulmonary embolism with thrombectomy.