Successful treatment of postoperative massive pulmonary embolism with paradoxal arterial embolism through extracorporeal life support and thrombolysis

Konstantinos Grapatsas; Vasileios Leivaditis; Paul Zarogoulidis; Zoi Tsilogianni; Sotirios Kotoulas; Christophoros Kotoulas; Efstratios Koletsis; Ilias Stylianos Iliadis; Konstantinos Spiliotopoulos; Georgia Trakada; Lemonia Veletza; Anastasios Kallianos; Theodora Tsiouda; Christoforos Kosmidis; Wolfgang Hohenforst-Schmidt; Haidong Huang; Rainer Haussmann; Erich Haussmann; Manfred Dahm

doi:10.1016/j.rmcr.2017.10.014

Successful treatment of postoperative massive pulmonary embolism with paradoxal arterial embolism through extracorporeal life support and thrombolysis

Respir Med Case Rep. 2017 Oct 31:23:1-3. doi: 10.1016/j.rmcr.2017.10.014. eCollection 2018.

Authors

Konstantinos Grapatsas^{1

2}, Vasileios Leivaditis¹, Paul Zarogoulidis³, Zoi Tsilogianni⁴, Sotirios Kotoulas², Christophoros Kotoulas², Efstratios Koletsis⁵, Ilias Stylianos Iliadis², Konstantinos Spiliotopoulos⁶, Georgia Trakada³, Lemonia Veletza³, Anastasios Kallianos³, Theodora Tsiouda³, Christoforos Kosmidis⁷, Wolfgang Hohenforst-Schmidt⁸, Haidong Huang⁹, Rainer Haussmann¹⁰, Erich Haussmann¹⁰, Manfred Dahm¹⁰

Affiliations

¹ Department of Cardiothoracic and Vascular Surgery, Westpfalz Klinikum, Academic Educational Hospital of Mainz University, Kaiserslautern, Germany.
² Department of Cardiothoracic Surgery, Iaso General, Athens, Greece.
³ Pulmonary-Oncology Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece.
⁴ Department of Pulmonology, 401 General Military Hospital, Athens, Greece.
⁵ Department of Cardiothoracic Surgery, Medical School, University Hospital of Patras, Patras, Greece.
⁶ Cardiothoracic Services, The Newcastle upon Tyne Hospitals NHS Foundation Trust, UK.
⁷ Surgery Department, "Interbalkan European Medical Center", Thessaloniki, Greece.
⁸ Sana Clinic Group Franken, Department of Cardiology/Pulmonology/Intensive Care/Nephrology, "Hof'' Clinics, University of Erlangen, Hof, Germany.
⁹ Department of Respiratory and Critical Care Medicine, Changhai Hospital, Second Military Medical University, Shanghai, China.
¹⁰ Department of Anesthesiology, Emergency Care Medicine and Intensive Care Medicine, Westpfalz Klinikum, Academic Educational Hospital of Mainz University, Kaiserslautern, Germany.

Abstract

Pulmonary embolism is a common clinical entity related to high mortality. About 200,000 to 300,000 patients die every year due to pulmonary embolism. The purpose of this article is to describe a case of a patient who on the second postoperative day after undergoing thromboembolectomy of the left femoral artery, manifested a massive pulmonary embolism. Due to cardiorespiratory collapse a combined treatment via extracorporeal life support (ECLS) and parallel catheter thrombolysis was decided and performed. By cardiorespiratory improvement and final stabilization the patient was successfully weaned from ECLS and the system was successfully removed. After a reasonable postoperative time the patient was dismissed in good overall condition.

Keywords: Catheter thrombolysis; Extracorporeal membrane oxygenation; Pulmonary embolism; Thrombolysis.

Publication types

Case Reports