CASE REPORT  THORACIC PAPERS 

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

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

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.