title: Successful Surgical Pulmonary Embolectomy for Massive Perinatal Embolism after Emergency Cesarean Section.
abstract: Pregnant women are exposed to an increased risk for developing pulmonary embolism (PE), a main cause for maternal mortality. Surgical pulmonary embolectomy is one important therapeutic and potential life-saving armamentarium, considering pregnancy as a relative contraindication for thrombolysis. We present a case of a 36-year-old woman with massive bilateral PE after emergent caesarean delivery, requiring reanimation by external heart massage. The onset of massive intrauterine bleeding contraindicated thrombolysis and emergency surgical pulmonary embolectomy, followed by a hysterectomy, were preformed successfully. Acute surgical pulmonary embolectomy may be an option in critically diseased high-risk patients, requiring a multiteam approach, and should be part of the therapeutic armamentarium of the attending cardiac surgeon.
authors.affiliation: Department of Cardiovascular Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Colombier
authors.affiliation: Department of Cardiovascular Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland. Electronic address: lars.niclauss@chuv.ch.
authors.forename: Lars
authors.initials: L
authors.lastname: Niclauss
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D017548:Echocardiography, Transesophageal; D017128:Embolectomy; D004630:Emergencies; D005260:Female; D006336:Heart Massage; D006801:Humans; D007044:Hysterectomy; D006473:Postpartum Hemorrhage / Q000209:etiology / Q000601:surgery; D011247:Pregnancy; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome