Best Anyama1,2, Omar Viswanath3, Carolina De La Cuesta4, Murlikrishna Kannan5, Michael Wittels6, Steve Xydas7, Alan David Kaye2, David A Farcy4,8. 1. Department of Surgery, Mount Sinai Medical Center, Miami Beach, FL. 2. Department of Anesthesiology, Louisiana State University Health Sciences Center, New Orleans, LA. 3. Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA. 4. Division of Critical Care, Mount Sinai Medical Center, Miami Beach, FL. 5. Integrated Anesthesia Medical Group, Manhattan Beach, CA. 6. Division of Orthopedic Surgery, Mount Sinai Medical Center, Miami Beach, FL. 7. Department of Cardiac and Thoracic Surgery, Mount Sinai Medical Center, Miami Beach, FL. 8. Department of Emergency Medicine, Mount Sinai Medical Center, Miami Beach, FL.
Abstract
BACKGROUND: A massive pulmonary embolism (PE) is associated with high mortality once cardiac arrest occurs. Surgical embolectomy is indicated in patients who have massive PE. CASE REPORT: A 62-year-old male emergently underwent surgical embolectomy after sustaining an intraoperative cardiac arrest caused by a massive PE during an open reduction with internal fixation of a closed comminuted midshaft tibia fracture. Postoperatively, the patient developed pulmonary hypertension and acute renal failure. He was treated with aerosolized epoprostenol for right ventricular strain secondary to pulmonary hypertension. He survived the hospital course and was discharged without any other major complications. CONCLUSION: Surgical embolectomy is a viable option for massive PE, and aerosolized epoprostenol can be used as adjuvant treatment for right ventricular strain secondary to acute pulmonary hypertension.
BACKGROUND: A massive pulmonary embolism (PE) is associated with high mortality once cardiac arrest occurs. Surgical embolectomy is indicated in patients who have massive PE. CASE REPORT: A 62-year-old male emergently underwent surgical embolectomy after sustaining an intraoperative cardiac arrest caused by a massive PE during an open reduction with internal fixation of a closed comminuted midshaft tibia fracture. Postoperatively, the patient developed pulmonary hypertension and acute renal failure. He was treated with aerosolized epoprostenol for right ventricular strain secondary to pulmonary hypertension. He survived the hospital course and was discharged without any other major complications. CONCLUSION: Surgical embolectomy is a viable option for massive PE, and aerosolized epoprostenol can be used as adjuvant treatment for right ventricular strain secondary to acute pulmonary hypertension.
Authors: I Kürkciyan; G Meron; F Sterz; K Janata; H Domanovits; M Holzer; A Berzlanovich; H C Bankl; A N Laggner Journal: Arch Intern Med Date: 2000-05-22
Authors: Robert C Neely; John G Byrne; Igor Gosev; Lawrence H Cohn; Quratulain Javed; James D Rawn; Samuel Z Goldhaber; Gregory Piazza; Sary F Aranki; Prem S Shekar; Marzia Leacche Journal: Ann Thorac Surg Date: 2015-07-10 Impact factor: 4.330