Affiliation:
1. Cardiovascular Perfusion Services, University of Michigan Hospitals, USA,
2. Cardiovascular Perfusion Services, University of Michigan Hospitals, USA
3. Department of Surgery & Anesthesia, ECMO Program, Cardiovascular Intensive Care Unit, Section of Cardiac Surgery, University of Michigan Hospitals, USA
Abstract
Massive pulmonary embolism (PE) is associated, historically, with a high mortality rate.Treatment options include systemic anticoagulation, catheter-directed thrombolytic therapy, surgical embolectomy, fragmentation techniques, and catheter embolectomy. Extracorporeal membrane oxygenation (ECMO) repeatedly has demonstrated effectiveness in providing cardiopulmonary support for the patient with a massive PE too unstable to undergo thrombolysis or embolectomy. The present case study describes a morbidly obese patient, status post gastric bypass surgery, who presented with PE, and acute respiratory and cardiac failure. A description of the patient’s management plan, which includes a simple, rapidly deployed ECMO system (Levitronix® CentriMag® and Jostra Quadrox D), systemic- and catheter-directed thrombolytic therapy and rheolytic thrombectomy (AngioJet® Series 3000, Possis Medical, Minneapolis, MN).
Subject
Advanced and Specialised Nursing,Cardiology and Cardiovascular Medicine,Safety Research,Radiology Nuclear Medicine and imaging,General Medicine
Cited by
13 articles.
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