Life-saving emergency pulmonary thromboembolectomy in a case of acute massive pulmonary thromboembolism with syncope Shumpei Okubo 1 , Hideki Kobayashi 1 , Masahiro Naito 1 , Norifumi Nakanishi 1 , Yoshikazu Obayashi 1 , Takaji Kaneko 1 , Tohru Sawada 1 , Takeyoshi Kunieda 1 , Motomi Ando 2 , Shigeaki Uemura 2 , Nobuyuki Nakajima 2 , Takao Yoshioka 3 , Katsuo Tazawa 4 1Department of Medicine, National Cardiovascular Center 2Department of Surgery, National Cardiovascular Center 3Research Institute, National Cardiovascular Center 4Department of Medicine, Mukaiyama Hospital pp.673-677
Published Date 1987/6/15
DOI https://doi.org/10.11477/mf.1404205080
  • Abstract
  • Look Inside

Life-saving emergency pulmonary thromboembo-lectomy in a case of acute massive pulmonary thro-mboembolism with syncope was reported. A 34 year-old man was admitted because of exertional dyspnea. His chest X-ray film, ECG, and arterial blood gas suggested the presence of pulmonary thromboem-bolism. Perfusion lung scan demonstrated multiple perfusion defects, and right-sided cardiac catheteriza-tion showed that the pulmonary arterial pressurewas elevated (mean ; 36 mmHg) and the cardiac in-dex was decreased (2. 4l/min/m2). Pulmonary arteri-ogram revealed multiple filling defects and cut-offs in both sides of the artery. Diagnosis of recurrent pulmonary thromboembolism was made. Sudden cardiovascular collapse occured with syncope and his clinical condition did not improve despite large doses of bolus infusion of urokinase. Emergency pulmonary thromboembolectomy was done one hour after the collapse, and the patient recovered well with some neurological deficit.

Copyright © 1987, Igaku-Shoin Ltd. All rights reserved.


電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院