title: Emergent surgical pulmonary embolectomy in a pregnant woman: case report and literature review.
abstract: Acute pulmonary embolism is a leading cause of death during pregnancy and delivery in the United States. We describe the case of a 25-year-old woman who presented in cardiogenic shock in week 38 of her first pregnancy. After the emergent cesarean delivery of a healthy male neonate, the mother underwent immediate surgical pulmonary embolectomy. We confirmed the diagnosis of pulmonary embolism intraoperatively by means of transesophageal echocardiography and removed large clots from the patient's pulmonary arteries. Mother and child were doing well, 27 months later. In addition to presenting our patient's case, we discuss the other relevant reports and the options for treating massive pulmonary embolism during pregnancy.
authors.affiliation: Departments of Cardiovascular Surgery (Drs. Matin, Peivandi, and Saeed), Internal Medicine II and Cardiology (Drs. Gradaus, Möller, and Neuzner), Gynecology and Obstetrics (Drs. Dimpfl and Stein), and Anesthesiology and Intensive Care Medicine (Dr. Langebrake), Klinikum Kassel GmbH, 34125 Kassel, Germany.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Saeed
authors.affiliation: Departments of Cardiovascular Surgery (Drs. Matin, Peivandi, and Saeed), Internal Medicine II and Cardiology (Drs. Gradaus, Möller, and Neuzner), Gynecology and Obstetrics (Drs. Dimpfl and Stein), and Anesthesiology and Intensive Care Medicine (Dr. Langebrake), Klinikum Kassel GmbH, 34125 Kassel, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Möller
authors.affiliation: Departments of Cardiovascular Surgery (Drs. Matin, Peivandi, and Saeed), Internal Medicine II and Cardiology (Drs. Gradaus, Möller, and Neuzner), Gynecology and Obstetrics (Drs. Dimpfl and Stein), and Anesthesiology and Intensive Care Medicine (Dr. Langebrake), Klinikum Kassel GmbH, 34125 Kassel, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Neuzner
authors.affiliation: Departments of Cardiovascular Surgery (Drs. Matin, Peivandi, and Saeed), Internal Medicine II and Cardiology (Drs. Gradaus, Möller, and Neuzner), Gynecology and Obstetrics (Drs. Dimpfl and Stein), and Anesthesiology and Intensive Care Medicine (Dr. Langebrake), Klinikum Kassel GmbH, 34125 Kassel, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Gradaus
authors.affiliation: Departments of Cardiovascular Surgery (Drs. Matin, Peivandi, and Saeed), Internal Medicine II and Cardiology (Drs. Gradaus, Möller, and Neuzner), Gynecology and Obstetrics (Drs. Dimpfl and Stein), and Anesthesiology and Intensive Care Medicine (Dr. Langebrake), Klinikum Kassel GmbH, 34125 Kassel, Germany.
authors.forename: Werner
authors.initials: W
authors.lastname: Stein
authors.affiliation: Departments of Cardiovascular Surgery (Drs. Matin, Peivandi, and Saeed), Internal Medicine II and Cardiology (Drs. Gradaus, Möller, and Neuzner), Gynecology and Obstetrics (Drs. Dimpfl and Stein), and Anesthesiology and Intensive Care Medicine (Dr. Langebrake), Klinikum Kassel GmbH, 34125 Kassel, Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Langebrake
authors.affiliation: Departments of Cardiovascular Surgery (Drs. Matin, Peivandi, and Saeed), Internal Medicine II and Cardiology (Drs. Gradaus, Möller, and Neuzner), Gynecology and Obstetrics (Drs. Dimpfl and Stein), and Anesthesiology and Intensive Care Medicine (Dr. Langebrake), Klinikum Kassel GmbH, 34125 Kassel, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Dimpfl
authors.affiliation: Departments of Cardiovascular Surgery (Drs. Matin, Peivandi, and Saeed), Internal Medicine II and Cardiology (Drs. Gradaus, Möller, and Neuzner), Gynecology and Obstetrics (Drs. Dimpfl and Stein), and Anesthesiology and Intensive Care Medicine (Dr. Langebrake), Klinikum Kassel GmbH, 34125 Kassel, Germany.
authors.forename: Meradjoddin
authors.initials: M
authors.lastname: Matin
authors.affiliation: Departments of Cardiovascular Surgery (Drs. Matin, Peivandi, and Saeed), Internal Medicine II and Cardiology (Drs. Gradaus, Möller, and Neuzner), Gynecology and Obstetrics (Drs. Dimpfl and Stein), and Anesthesiology and Intensive Care Medicine (Dr. Langebrake), Klinikum Kassel GmbH, 34125 Kassel, Germany.
authors.forename: Ali
authors.initials: A
authors.lastname: Peivandi
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000379:methods*; D017548:Echocardiography, Transesophageal / Q000379:methods; D017128:Embolectomy / Q000379:methods*; D004638:Emergency Treatment / Q000379:methods; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D011651:Pulmonary Artery / Q000601:surgery; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D012770:Shock, Cardiogenic / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome
keywords: Cesarean section; embolectomy/methods; pregnancy complications, cardiovascular/diagnosis/surgery; pregnancy outcome; pregnancy trimester, third; pulmonary embolism/complications/surgery; risk assessment; thrombosis/surgery; treatment outcome; ventricular dysfunction, right/etiology