Successful thrombolysis after pulmonary embolectomy for persistent massive postoperative pulmonary embolism

被引:7
作者
Spöhr, F
Rehmert, GC
Böttiger, BW
Hagl, S
Gries, A
机构
[1] Heidelberg Univ, Dept Anesthesiol, D-69120 Heidelberg, Germany
[2] Heidelberg Univ, Dept Cardiac Surg, D-69120 Heidelberg, Germany
关键词
embolectomy; haemorrhage; postoperative complications; pulmonary embolism; thrombolytic therapy;
D O I
10.1016/j.resuscitation.2004.01.029
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
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. (C) 2004 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:113 / 118
页数:6
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