Successful thrombolysis after pulmonary embolectomy for persistent massive postoperative pulmonary embolism

Resuscitation
Fabian SpöhrAndré Gries

Abstract

Massive postoperative pulmonary embolism (PE) is associated with a poor prognosis in patients presenting with haemodynamic instability. Since recent surgery is a commonly accepted contraindication for thrombolytic therapy, pulmonary embolectomy is an appropriate therapeutic approach in these patients. If life-threatening symptoms of PE persist after pulmonary embolectomy, however, very few other therapeutic options are available. We report the successful use of locally administered low-dose thrombolysis 2 days after pulmonary embolectomy in a patient with postoperative PE and persistent severe hypoxaemia and pulmonary hypertension. During and after thrombolysis, no bleeding complications occurred. We conclude that low-dose thrombolysis for PE may be considered even in patients who have recently undergone major thoracic and abdominal surgery if embolectomy and continued intravenous heparin have failed to be successful and life-threatening symptoms of PE persist.

References

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Citations

Mar 9, 2005·Der Anaesthesist·F SpöhrA Walther
Sep 12, 2015·Annals of Thoracic and Cardiovascular Surgery : Official Journal of the Association of Thoracic and Cardiovascular Surgeons of Asia·Felix Samuel ShonyelaJia Jiao
Mar 21, 2006·Current Opinion in Anaesthesiology·Johann MotschBernd W Böttiger
Mar 18, 2020·Pulmonary Circulation·Mads Dam LyhneAsger Andersen

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