Thrombolytic therapy complemented by ECMO: successful treatment for a case of massive pulmonary thromboembolism with hemodynamic collapse.
Pulmonary thromboembolism (PTE) is a common clinical condition related to significant mortality. Furthermore, patients with PTE presenting with right heart thrombus show higher mortality due to rapid hemodynamic deterioration. But the optimal treatment of massive PTE is controversial although various methods have been developed and improved. Here, we presented a case of 56-yr-old woman with massive PTE showing hemodynamic collapse, who was successfully treated with extracorporeal membrane oxygenation (ECMO) adjunct to thrombolytic therapy even without thrombectomy. ECMO was useful for resuscitation and stabilization of the cardiopulmonary function. In conclusion, thrombolytic therapy complemented by ECMO may be an effective treatment option for acute massive PTE with hemodynamic instability.
Division of Cardiology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.
Min Ku
MK
Chon
Division of Cardiology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.
Yong Hyun
0000-0001-6122-214X
YH
Park
Division of Cardiology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.
Jin Hee
JH
Choi
Division of Cardiology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.
Sang Hyun
SH
Lee
Division of Cardiology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.
Jeong Su
JS
Kim
Division of Cardiology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.
Jun
J
Kim
Division of Cardiology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.
June Hong
JH
Kim
Division of Cardiology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.
Kook Jin
KJ
Chun
D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006321:Heart / Q000503:physiopathology; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D011651:Pulmonary Artery / Q000503:physiopathology*; D011655:Pulmonary Embolism / Q000628:therapy*; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D020246:Venous Thrombosis / Q000503:physiopathology*; D014859:Warfarin / Q000627:therapeutic use
D014859:Warfarin; D006493:Heparin; D010959:Tissue Plasminogen Activator
Extracorporeal Membrane Oxygenation, Percutaneous Cardiopulmonary Support; Pulmonary Thromboembolism; Thrombolysis