Key result
Surgical embolectomy and aerosolized epoprostenol successfully rescue a patient from massive PE-induced intraoperative cardiac arrest.
Why the study?
Massive pulmonary embolism causing intraoperative cardiac arrest has high mortality, and the role of emergent surgical embolectomy in this setting requires illustration.
Case Report (n=1)
Emergent surgical embolectomy and adjuvant aerosolized epoprostenol can be successfully used to treat massive pulmonary embolism causing intraoperative cardiac arrest.
May support rescue in intraoperative massive PE arrest; single case leaves open need for prospective validation before practice change.
BACKGROUND: A massive pulmonary embolism (PE) is associated with high mortality once cardiac arrest occurs. Surgical embolectomy is indicated in patients who have massive PE. CASE REPORT: A 62-year-old male emergently underwent surgical embolectomy after sustaining an intraoperative cardiac arrest caused by a massive PE during an open reduction with internal fixation of a closed comminuted midshaft tibia fracture. Postoperatively, the patient developed pulmonary hypertension and acute renal failure. He was treated with aerosolized epoprostenol for right ventricular strain secondary to pulmonary hypertension. He survived the hospital course and was discharged without any other major complications. CONCLUSION: Surgical embolectomy is a viable option for massive PE, and aerosolized epoprostenol can be used as adjuvant treatment for right ventricular strain secondary to acute pulmonary hypertension.
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Anyama et al. (2018) conducted a case report in Massive pulmonary embolism causing intraoperative cardiac arrest (n=1). Emergent surgical embolectomy and aerosolized epoprostenol was evaluated on Survival to hospital discharge. Emergent surgical embolectomy and adjuvant aerosolized epoprostenol successfully treated a patient who suffered an intraoperative cardiac arrest due to a massive pulmonary embolism.
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