Percutaneous cardiopulmonary support (PCPS) can serve as an effective adjunctive therapy for severe acute pulmonary thromboembolism complicated by right ventricular thrombus due to large uterine leiomyomata.
May support PCPS consideration in rare PE with RV thrombus from leiomyomata; hypothesis-generating and should not yet change practice.
OBJECTIVE: Acute pulmonary thromboembolism (PTE) is a common illness that causes death and disability. Deep vein thrombosis (DVT) is often found in patients with a large myomatous uterus, and can occasionally result in acute PTE. Here, we describe the achievement of a favorable outcome in a case of acute PTE. CASE REPORT: The patient presented with acute PTE caused by a large uterine leiomyoma, without DVT of the lower extremities. Percutaneous cardiopulmonary support (PCPS) was used as an adjunct to thrombolytic therapy to treat the right ventricular thrombus with acute PTE. According to emergency practice, PCPS was initiated, and the patient was successfully treated with thrombolytic and anticoagulant therapy associated with total abdominal hysterectomy. CONCLUSIONS: This case suggests that PCPS can lead to favorable clinical outcomes in patients with large uterine leiomyomata and severe PTE.
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Kurakazu et al. (2012) studied this question.
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