[Acute heart arrest during urologic routine interventions in 2 cases. Interdisciplinary crisis management assures tumor-free survival despite fulminant lung embolism with acute heart arrest during thoraco-abdominal tumor nephrectomy and radical cystoprostatovesiculectomy].
Intraoperative pulmonary embolism with acute cardiac arrest can successfully be managed by immediate open cardiac massage followed by rt-PA injection, an inter-disciplinary approach is mandatory. The scheduled tumor nephrectomy was performed 6 weeks after the initial event. The tumor was embolised with intravascular coils placed in a supraselective manner by the radiologist. During the secondary procedure it was found to be necrotic. In the second case the event occurred at the end of a radical cystectomy. Instead of an ileal conduit cutaneous ureterostomies were used for urinary drainage after cardiac output had been restored and rt-PA had been administered.
Rudolf
H W
HW
Klinik für Anaesthesie und operative Intensivmedizin, Robert-Koch-Krankenhaus, Gehrder.
Fröhlich
H
H
Schick
V
V
D000368:Aged; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D002295:Carcinoma, Transitional Cell / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D004621:Embolization, Therapeutic; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006336:Heart Massage; D006801:Humans; D007431:Intraoperative Complications / Q000628:therapy*; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009392:Nephrectomy; D011468:Prostatectomy; D011655:Pulmonary Embolism / Q000628:therapy*; D012086:Reoperation; D012151:Resuscitation / Q000379:methods*; D015912:Thrombolytic Therapy; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery*
Akuter Herzstillstand während urologischer Routineeingriffe in 2 Fällen. Interdisziplinäres Krisenmanagement sichert tumorfreies Uberleben trotz fulminanter Lungenembolie mit akutem Herzstillstand während einer thorakoabdominalen Tumornephrektomie und einer radikalen Zystoprostatovesikulektomie.