Thrombolytic therapy complemented by ECMO: successful treatment for a case of massive pulmonary thromboembolism with hemodynamic collapse

J Korean Med Sci. 2014 May;29(5):735-8. doi: 10.3346/jkms.2014.29.5.735. Epub 2014 Apr 25.

Abstract

Pulmonary thromboembolism (PTE) is a common clinical condition related to significant mortality. Furthermore, patients with PTE presenting with right heart thrombus show higher mortality due to rapid hemodynamic deterioration. But the optimal treatment of massive PTE is controversial although various methods have been developed and improved. Here, we presented a case of 56-yr-old woman with massive PTE showing hemodynamic collapse, who was successfully treated with extracorporeal membrane oxygenation (ECMO) adjunct to thrombolytic therapy even without thrombectomy. ECMO was useful for resuscitation and stabilization of the cardiopulmonary function. In conclusion, thrombolytic therapy complemented by ECMO may be an effective treatment option for acute massive PTE with hemodynamic instability.

Keywords: Extracorporeal Membrane Oxygenation, Percutaneous Cardiopulmonary Support; Pulmonary Thromboembolism; Thrombolysis.

Publication types

  • Case Reports

MeSH terms

  • Extracorporeal Membrane Oxygenation*
  • Female
  • Heart / physiopathology
  • Heparin / therapeutic use
  • Humans
  • Middle Aged
  • Myocardium / pathology
  • Pulmonary Artery / physiopathology*
  • Pulmonary Embolism / therapy*
  • Thrombolytic Therapy*
  • Tissue Plasminogen Activator / therapeutic use
  • Venous Thrombosis / physiopathology*
  • Warfarin / therapeutic use

Substances

  • Warfarin
  • Heparin
  • Tissue Plasminogen Activator