| Surgical Salvage
of Acute Pulmonary Thromboembolism Supported by a Percutaneous
Cardiopulmonary Bypass System |
(Department of Cardiovascular Surgery, Nagoya Second
Red Cross Hospital, Nagoya, Japan)
| Yoshimori Araki |
Kazuyoshi Tajima |
Jiniti Iwase |
| Tomonobu Abe |
Wataru Kato |
Keisuke Tanaka |
| Akinori Io |
Yoshito Suenaga |
|
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We report a 66-year-old woman with
circulatory collapse due to acute pulmonary thromboembolism,
in whom a left nephrectomy for a renal tumor was scheduled. Following
preoperative renal angiography. The patient suffered sudden shock
resulting from pulmonary thromboembolism (PTE) following release
of compression of the puncture site. The patient was transported
to the ICU, and percutaneous cardiopulmonary support (PCPS) was
instituted immediately for resuscitation. Hemodynamics were stabilized
by PCPS and percutaneous thrombectomy was attempted. However,
perforation by a catheter inverted to the extracardiac space
occurred, which neccesitated emergency surgical hemostasis. PCPS
was converted to cardiopulmonary bypass (CPB). The injured right
ventricle and right atrial walls were repaired, and pulmonary
thrombectomy was performed via the pulmonary trunk. CPB was easily
terminated and her postoperative course was uneventful with anticoagulant
therapy. Left nephrectomy was performed two months later. PTE
recurred due to the interruption of anticoagulation for surgical
treatment of a renal tumor. Percutaneous pulmonary thrombectomy
and thrombolysis therapy were effective and a Greenfield filter
was inserted into the inferior vena cava to prevent recurrence.
Jpn. J. Cardiovasc. Surg. 29: 122-125 (2000) |
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