[Thromboembolectomy using cardiopulmonary bypass for acute pulmonary embolism with nephrotic syndrome--report of a case].
We report a case treated with thromboembolectomy using cardiopulmonary bypass for acute pulmonary embolism caused by nephrotic syndrome. A 19-year-old male with poorly controlled nephrotic syndrome was admitted associating with severe shock. An acute pulmonary embolism was diagnosed by ECG and echocardiography. Despite the intensive thrombolytic therapy, hemodynamics was deteriorated. Pulmonary arteriography demonstrated obstruction of left main pulmonary artery and partial defects of right pulmonary artery bifurcation and right middle-lower pulmonary arteries. An emergent thromboembolectomy using cardiopulmonary bypass was performed successfully. In conclusion, an emergent surgical treatment is required in the case of acute massive pulmonary thromboembolism which shows hemodynamic deterioration in spite of recent intensive medical treatment.
First Department of Surgery, Hiroshima University School of Medicine, Japan.
K
K
Tahara
T
T
Sueda
H
H
Shikata
K
K
Orihashi
N
N
Mitsui
Y
Y
Matsuura
D000208:Acute Disease; D000328:Adult; D002315:Cardiopulmonary Bypass; D017128:Embolectomy; D006801:Humans; D008297:Male; D009404:Nephrotic Syndrome / Q000150:complications*; D011655:Pulmonary Embolism / Q000209:etiology / Q000601:surgery*; D017131:Thrombectomy