title: [Acute massive pulmonary thromboembolism with cardiac arrest].
abstract: Acute massive pulmonary thromboembolism (APE) is still associated with a high mortality rate. Furthermore, significantly higher mortality rates are observed in patients who underwent cardiopulmonary resuscitation (CPR) because of severe brain damage or multiple organ failure. We present successfully treated 4 patients who were transferred from outside hospitals under continuous CPR. Three of 4 patients required percutaneous cardiopulmonary support (PCPS). Preoperatively, all 4 patients had no brain damage despite of CPR for a maximum of 40 minutes. Open pulmonary thrombectomy was successfully performed under on pump beating cardiopulmonary support. All patients dramatically improved and were discharged without any complication. When hemodynamic instability or cardiac arrest occurs in patients with APE, rapid CPR, rapid diagnosis with echocardiography, and quick PCPS establishment are keys in our management strategy.
authors.affiliation: Department of Cardiovascular Surgery, Tajimi Hospital, Tajimi, Japan.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Matsuyama
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Nakayama
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Hagiwara
mesh_terms: D000368:Aged; D016887:Cardiopulmonary Resuscitation; D005260:Female; D006323:Heart Arrest / Q000209:etiology*; D006801:Humans; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000150:complications* / Q000628:therapy