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- Yusuke Watanabe, Kenichi Sakakura, Naoyuki Akashi, Mami Ishikawa, Yousuke Taniguchi, Kei Yamamoto, Hiroshi Wada, Hideo Fujita, and Momomura Shin-Ichi SI Department of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University..
- Department of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University.
- Int Heart J. 2017 Oct 21; 58 (5): 831-834.
AbstractWhile most of pulmonary thromboembolism (PE) cases can be managed by thrombolytic and anticoagulation therapy, massive PE remains a life-threatening disease. Although surgical embolectomy can be a curative therapy for massive PE, peri-operative mortality for hemodynamically collapsed PE is extremely high. We present a case of hemodynamically collapsed massive PE. We avoided either thrombolytic therapy or surgical embolectomy, because the patient had recent cerebral contusion. Therefore, we managed the patient with the combination of veno-arterial extracorporeal membrane oxygenation (V-A ECMO) and conventional anticoagulation, which dramatically improved the patient's hemodynamics. In conclusion, the combination of V-A ECMO and conventional anticoagulation may be the preferred first line therapy for the patients with cardiogenic shock following massive PE.
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