Life-Threatening Acute on Chronic Pulmonary Thromboembolism Requiring Extracorporeal Membrane Oxygenation

Abstract

A 71-year-old female patient was admitted to the emergency department with sudden aggravation of chest pain and severe dyspnea. Computed tomography showed extensive pulmonary thromboembolism. Venoarterial extracorporeal membrane oxygenation (ECMO) was instituted due to sudden bradycardia and hypotension. An emergency operation was performed. However, chronic pulmonary thromboembolism combined with an acute pulmonary embolism was detected in the operating room. Embolectomy and endarterectomy were performed. ECMO was then discontinued. The patient was discharged on postoperative day 13 with warfarin for anticoagulation. The patient was followed up for 46 months as an outpatient without further thromboembolic events.

Pulmonary hypertension: when the acute event leads to diagnosis. Case report in a patient with Ehlers-Danlos syndrome.

“…A similar case report with surgical management has been described in other paper. 14 Another interesting element of this case report concerns the fact that the patient suffered from EDS. EDS comprises a group of hereditary connective tissue disorders in which collagen synthesis and fibrogenesis is impaired.…”

Rescue balloon pulmonary angioplasty for life-threatening acute pulmonary embolism on chronic thromboembolic pulmonary hypertension patients

“…Hence, there was no indication for thrombolysis. Lee et al reported a case of acute PE on chronic pulmonary thromboembolism requiring ECMO that was treated with pulmonary embolectomy and PEA [ 6 ]. PEA should be considered for operable CTEPH.…”