Key result
VA-ECMO supports full recovery and discharge in massive pulmonary embolism with cardiogenic shock.
Case Report (n=1)
No
This case highlights the vital multidisciplinary role of cardiac anesthesiologists in managing complex ECMO therapy for patients with cardiogenic shock due to massive pulmonary embolism.
VA-ECMO supported recovery in one massive PE shock case; hypothesis-generating and should not yet change practice.
We present a case of a 35-year-old male who presented with sudden-onset severe chest pain and breathlessness. CTPA revealed massive bilateral pulmonary embolism. The patient underwent catheter-directed mechanical thrombectomy (CDMT) under general anesthesia, complicated by cardiogenic shock necessitating cardiopulmonary resuscitation (CPR). Post ROSC, venoarterial ECMO was initiated, and catheter-directed thrombolysis was performed. CDMT was reattempted but not fully successful, and the patient developed right heart failure with pulmonary hypertension. ECMO continued for 5 days and gradually weaned off. He was extubated successfully on Day 7 and discharged home later.
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Varma et al. (2025) conducted a case report in Massive pulmonary embolism with cardiogenic shock (n=1). Venoarterial ECMO and multidisciplinary intensive care was evaluated on Clinical recovery and survival to discharge. Venoarterial ECMO and multidisciplinary intensive care management facilitated the successful weaning, extubation, and discharge of a 35-year-old male with cardiogenic shock following massive pulmonary embolism.
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