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THE JOURNAL OF CARDIOVASCULAR SURGERY

The Journal of Cardiovascular Surgery 1999 Febbraio;40(1):165-7

THORACIC PAPERS 

    CASE REPORT

Pulmonary embo­lec­to­my for ­acute mas­sive pul­mo­nary embo­lism under per­cut­ane­ous car­di­o­pul­mo­nary sup­port

Sudo K., Ide H., Fujiki T., Tonari K., Nasu Y., Ikeda K.

From the Department of Cardiovascular Surgery Kyorin University, Mitaka City, Tokyo, Japan

Portable per­cut­ane­ous car­di­o­pul­mo­nary sup­port (­PCPS) ­with hep­ar­in-coat­ed cir­cuits and a bio­pump was ­employed in a ­patient who had a mas­sive pul­mo­nary embo­lism ­with cir­cu­la­to­ry col­lapse ­after strip­ping of var­i­cos­ities of the leg. Emergency pul­mo­nary embo­lec­to­my was suc­cess­ful­ly per­formed. The ­main pul­mo­nary inci­sion was facil­i­tat­ed by ­cross-clamp­ing of the ­main pul­mo­nary arte­ri­al ­root. The ­bypass cir­cuit was ­kept ­closed, and ­used ­with the nor­mo­ther­mic beat­ing ­heart with­out con­vert­ing to con­ven­tion­al ­total car­di­o­pul­mo­nary ­bypass. Blood ­flow ­from the ­lung was ­removed by ­pump suc­tion, ­stored in the res­er­voir, and inter­mit­tent­ly ­returned to the ­venous cir­cu­la­tion. Heparin was add­ed to the cir­cuits to ­keep the acti­vat­ed clot­ting ­time great­er ­than 300 sec. In mas­sive pul­mo­nary embo­lism, ­PCPS is use­ful for pre­op­er­a­tive, intra­op­er­a­tive, and post­op­er­a­tive sup­port.

lingua: Inglese


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