Percutaneous cardiopulmonary support for treatment of massive pulmonary embolism

• Published in: Journal of artificial organs Vol. 5; no. 4; pp. 228 - 232
• Main Authors: Tayama, E., Takaseya, T., Hiratsuka, R., Akasu, K., Teshima, H., Hayashida, N., Fukunaga, S., Akashi, H., Kawara, T., Aoyagi, S.
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Nature B.V 01.12.2002
• Subjects: Drug therapy; Medical research
• ISSN: 1434-7229; 1619-0904
• DOI: 10.1007/s100470200043

The management of massive pulmonary embolism remains difficult, particularly when cardiogenic shock is involved. In an attempt to rescue and maintain the preoperative circulatory condition, seven patients with acute pulmonary embolism were given percutaneous cardiopulmonary support (PCPS). The circulation, respiratory condition, and urinary output were all improved after PCPS induction. Two patients died of profound cardiogenic shock before the operation. Five patients underwent surgical embolectomy. Postoperatively, all patients who underwent embolectomy were continuously assisted with PCPS. The overall survival rate after PCPS induction was 42.9% (3/7), and the success rate of surgical embolectomy was 60% (3/5). One of the major complications associated with PCPS was bleeding, which can be associated with preoperative thrombolysis. The use of PCPS immediately resuscitated and stabilized the hemodynamic condition and allowed a successful emergency pulmonary embolectomy to be performed. Additionally, PCPS was effective for postoperative respiratory management, which is sometimes associated with reperfusion pulmonary edema.[PUBLICATION ABSTRACT]