[A case of chronic recurrent pulmonary embolism treated by pulmonary embolectomy and Günther vena caval filter implantation].
A case report of chronic recurrent pulmonary embolism treated by embolectomy and Günther vena caval filter. A 62-year-old man had suffered from dyspnea on effort for 4 years, and his feeling of dyspnea had gradually increased during the past 3 months. On the day of admission he was in a preshock state, and his pulmonary artery pressure was very high at 90/30 mmHg. Pulmonary blood perfusion scintigraphy showed multiple defects of isotope uptake. Immediately after the scintigraphy, pulmonary embolectomy was performed while using extracorporeal circulation. The operation was successful and his physical activity was markedly improved. After the operation, anti-coagulant and anti-platelet therapies were continued, but recurrence of pulmonary emboli was detected by scintigraphy, and some thrombi were found by venography in deep veins of the lower parts of both legs. To prevent recurrent pulmonary embolism, a Günther vena caval filter was inserted into the inferior vena cava. We considered this case as an acute worsening of chronic recurrent pulmonary embolism and we had the impression that pulmonary embolectomy is a very effective therapeutic method for serious pulmonary embolism, and that insertion of the Günther vena caval filter is a very easy and safe procedure.
3rd Department of Internal Medicine, Nagoya City University Medical School.
N
N
Ohte
T
T
Nagao
K
K
Hayakawa
T
T
Hashimoto
S
S
Nakano
T
T
Fujinami
T
T
Ishii
M
M
Hatoh
Y
Y
Takeda
Y
Y
Suzuki
D002908:Chronic Disease; D004452:Echocardiography; D004562:Electrocardiography; D006440:Hemofiltration / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000517:prevention & control / Q000601:surgery / Q000628:therapy*; D012008:Recurrence; D014682:Vena Cava, Inferior