Surgical Salvage of Acute Pulmonary Thronrboembolism Supported by a Percutaneous Cardiopulmonary Bypass System.

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Acute pulmonary thromboembolism (n=1). Intervention: Percutaneous cardiopulmonary support (PCPS) and surgical thrombectomy. Primary outcome: Patient survival and recovery.

Yoshimori Araki; Kazuyoshi Tajima; Jiniti Iwase; Tomonobu Abe; Wataru Kato; Keisuke Tanaka; Akinori Io; Yoshito Suenaga

doi:10.4326/jjcvs.29.122

January 1, 2000Japanese Journal of Cardiovascular SurgeryOpen Access

Surgical Salvage of Acute Pulmonary Thronrboembolism Supported by a Percutaneous Cardiopulmonary Bypass System.

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Key Points

To describe the emergency surgical management and salvage of a patient experiencing circulatory collapse from acute massive pulmonary thromboembolism complicated by catheter perforation.
Initiated percutaneous cardiopulmonary support during active cardiopulmonary resuscitation for cardiogenic shock in a 66-year-old female patient.
Converted to standard cardiopulmonary bypass to perform primary suture repair of an iatrogenic pericardial perforation and direct-vision pulmonary embolectomy via the main pulmonary artery.
The patient was successfully resuscitated, underwent complete surgical clot removal, and was smoothly weaned from cardiopulmonary bypass.
Recurrent pulmonary embolism following temporary anticoagulant discontinuation two months later was successfully resolved using catheter thrombectomy, thrombolytic therapy, and inferior vena cava filter placement.

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

P

Population

A 66-year-old woman with circulatory collapse due to acute pulmonary thromboembolism who underwent surgical salvage supported by PCPS.

I

Intervention

Percutaneous cardiopulmonary support (PCPS) for resuscitation followed by surgical pulmonary thrombectomy under cardiopulmonary bypass.

O

Outcome

Survival and clinical recoveryhard clinical

Limitations

Single case report limits generalizability
Complication of catheter perforation necessitated emergency surgical hemostasis
Recurrence of PTE occurred due to interruption of anticoagulation for subsequent surgery
Single case report
Inability to evaluate for deep vein thrombosis (DVT) initially due to difficulty securing peripheral vessels

Implication

Immediate institution of percutaneous cardiopulmonary support (PCPS) followed by surgical thrombectomy can be a life-saving strategy for patients with acute massive pulmonary thromboembolism presenting with circulatory collapse.

Abstract

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Discussion

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Cite This Study

Araki et al. (2000) conducted a case report in Acute pulmonary thromboembolism (n=1). Percutaneous cardiopulmonary support (PCPS) and surgical thrombectomy was evaluated on Patient survival and recovery.

synapsesocial.com/papers/6a93fa238a8748f227d6935f https://doi.org/10.4326/jjcvs.29.122

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Surgical Salvage of Acute Pulmonary Thronrboembolism Supported by a Percutaneous Cardiopulmonary Bypass System.

Key Points

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

Surgical Salvage of Acute Pulmonary Thronrboembolism Supported by a Percutaneous Cardiopulmonary Bypass System.

Key Points

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

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