Cardiovascular collapse during elective orthopedic surgery: massive intraoperative pulmonary thromboembolism treated with emergent cardiopulmonary bypass.
Successful management strategies for pulmonary thromboembolism-primarily published as case reports-include a spectrum ranging from medical treatment with cardiovascular support and anticoagulation to more invasive interventions such as pulmonary embolectomy. We present a case of massive intraoperative pulmonary embolism that was managed with emergent pulmonary embolectomy. Unlike previously reported cases, this aggressive management strategy was unsuccessful, due in part perhaps to lack of discernible clot during embolectomy.
Obray
Jon B
JB
Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, USA.
Long
Timothy R
TR
Rehfeldt
Kent H
KH
Wass
C Thomas
CT
D000328:Adult; D002315:Cardiopulmonary Bypass; D017548:Echocardiography, Transesophageal; D017128:Embolectomy; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D019637:Orthopedic Procedures / Q000009:adverse effects*; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D012769:Shock / Q000209:etiology; D017211:Treatment Failure