Postcesarean pulmonary embolism, sustained cardiopulmonary resuscitation, embolectomy, and near-death experience.
BACKGROUND
Survival after surgical embolectomy for massive postcesarean pulmonary embolism causing sustained cardiac arrest is rare.


METHODS
One day after an uneventful cesarean delivery, a woman developed cardiac asystole and apnea due to pulmonary embolism. Femoral-femoral cardiopulmonary bypass performed during continuous cardiopulmonary resuscitation allowed a successful embolectomy. Upon awakening, the patient reported a near-death experience. Pulmonary embolism causes approximately 2 deaths per 100,000 live births per year in the United States, and postcesarean pulmonary embolism is probably more common than pulmonary embolism after vaginal delivery.


CONCLUSIONS
Massive pulmonary embolism is a potentially treatable catastrophic event after cesarean delivery, even if continuous cardiopulmonary resuscitation is required until life-saving embolectomy is done.
Marty
Alan T
AT
Department of Cardiac Surgery, Saint Mary's Medical Center, Evansville, Indiana, and the Department of Psychiatric Medicine, Division of Personality Studies, University of Virginia, Charlottesville, Virginia, USA. aempmarty@aol.com
Hilton
Frank L
FL
Spear
Robert K
RK
Greyson
Bruce
B
D000208:Acute Disease; D000328:Adult; D002315:Cardiopulmonary Bypass / Q000379:methods*; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D017604:Cesarean Section, Repeat / Q000009:adverse effects; D003643:Death; D017128:Embolectomy / Q000379:methods* / Q000401:mortality; D004630:Emergencies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D049590:Postpartum Period; D011247:Pregnancy; D011655:Pulmonary Embolism / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D016896:Treatment Outcome