[A case report of massive pulmonary embolism with cardiac arrest at ICU--the effect of emergency percutaneous cardiopulmonary support system].
A 27-year-old female underwent a cesarean section because of a cephalopelvic disproportion. From the night of the operation, she complained of dyspnea and became in shock, and she was transferred to our department. A pulmonary perfusion scintigraphy revealed no right pulmonary artery flow and poor left lung perfusion. We diagnosed a massive pulmonary embolism (MPE). After the scintigraphy, the blood pressure went down and the heart was arrested. Under cardiac massage, percutaneous cannulation was done via right femoral artery and vein at ICU, and she was transferred to operative room with percutaneous cardiopulmonary support (PCPS). Emergency embolectomy was carried out with complete extracorporeal circulation. Three thrombi (total weight 20 g, the longest 15 cm) were removed through a longitudinal incision in the main pulmonary artery. The postoperative course was uneventful and, 1 month after the operation she was discharged. PCPS was a highly effective method for severe MPE.
Ookawa
Y
Y
Department of Emergency and Critical Care Medicine, Sapporo City General Hospital, Japan.
Kamata
K
K
Tanaka
A
A
Maekawa
K
K
Watanabe
N
N
D000328:Adult; D001243:Assisted Circulation; D002585:Cesarean Section; D005260:Female; D006323:Heart Arrest / Q000209:etiology*; D006801:Humans; D007362:Intensive Care Units; D011183:Postoperative Complications; D011247:Pregnancy; D011655:Pulmonary Embolism / Q000150:complications / Q000628:therapy*