Surgical pulmonary embolectomy on VA-ECMO

Surgical pulmonary embolectomy is a procedure that is often used to rescue patients with massive pulmonary embolism (PE) and circulatory collapse that have failed or may not be ideal candidates for other systemic and endovascular treatment modalities. This procedure typically involves a sternotomy a...

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Autores principales:	Rachel Steinhorn, Adam A. Dalia, Edward A. Bittner, Marvin G. Chang
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Case report Pulmonary embolectomy Pulmonary embolism VA-ECMO Cardiopulmonary bypass Extracorporeal membrane oxygenation Diseases of the respiratory system RC705-779
Acceso en línea:	https://doaj.org/article/0cb562adcfb54ab7bf927c272f1cc4ca
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spelling	oai:doaj.org-article:0cb562adcfb54ab7bf927c272f1cc4ca2021-11-24T04:29:02ZSurgical pulmonary embolectomy on VA-ECMO2213-007110.1016/j.rmcr.2021.101551https://doaj.org/article/0cb562adcfb54ab7bf927c272f1cc4ca2021-01-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2213007121002136https://doaj.org/toc/2213-0071Surgical pulmonary embolectomy is a procedure that is often used to rescue patients with massive pulmonary embolism (PE) and circulatory collapse that have failed or may not be ideal candidates for other systemic and endovascular treatment modalities. This procedure typically involves a sternotomy and the use of cardiopulmonary bypass (CPB), which requires full systemic anticoagulation. Here, we report the case of a surgical pulmonary embolectomy performed on venoarterial extracorporeal membrane oxygenation (VA-ECMO) rather than CPB to minimize systemic anticoagulation. The patient had suffered a cardiac arrest due to a saddle PE and required VA-ECMO which was complicated by a concomitant intracranial hemorrhage. The patient tolerated the surgical pulmonary embolectomy performed on VA-ECMO without procedure-related complications, and the ECMO support did not substantially complicate the technical performance of the procedure. In contrast to surgical pulmonary embolectomy performed on CPB, greater attention must be paid to volume status when performing the procedure on VA-ECMO since there is no blood reservoir. This case suggests cardiopulmonary support on ECMO as a viable strategy for surgical embolectomy in patients with unstable PEs in whom thrombolysis or full systemic anticoagulation are contraindicated.Rachel SteinhornAdam A. DaliaEdward A. BittnerMarvin G. ChangElsevierarticleCase reportPulmonary embolectomyPulmonary embolismVA-ECMOCardiopulmonary bypassExtracorporeal membrane oxygenationDiseases of the respiratory systemRC705-779ENRespiratory Medicine Case Reports, Vol 34, Iss , Pp 101551- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Case report Pulmonary embolectomy Pulmonary embolism VA-ECMO Cardiopulmonary bypass Extracorporeal membrane oxygenation Diseases of the respiratory system RC705-779
spellingShingle	Case report Pulmonary embolectomy Pulmonary embolism VA-ECMO Cardiopulmonary bypass Extracorporeal membrane oxygenation Diseases of the respiratory system RC705-779 Rachel Steinhorn Adam A. Dalia Edward A. Bittner Marvin G. Chang Surgical pulmonary embolectomy on VA-ECMO
description	Surgical pulmonary embolectomy is a procedure that is often used to rescue patients with massive pulmonary embolism (PE) and circulatory collapse that have failed or may not be ideal candidates for other systemic and endovascular treatment modalities. This procedure typically involves a sternotomy and the use of cardiopulmonary bypass (CPB), which requires full systemic anticoagulation. Here, we report the case of a surgical pulmonary embolectomy performed on venoarterial extracorporeal membrane oxygenation (VA-ECMO) rather than CPB to minimize systemic anticoagulation. The patient had suffered a cardiac arrest due to a saddle PE and required VA-ECMO which was complicated by a concomitant intracranial hemorrhage. The patient tolerated the surgical pulmonary embolectomy performed on VA-ECMO without procedure-related complications, and the ECMO support did not substantially complicate the technical performance of the procedure. In contrast to surgical pulmonary embolectomy performed on CPB, greater attention must be paid to volume status when performing the procedure on VA-ECMO since there is no blood reservoir. This case suggests cardiopulmonary support on ECMO as a viable strategy for surgical embolectomy in patients with unstable PEs in whom thrombolysis or full systemic anticoagulation are contraindicated.
format	article
author	Rachel Steinhorn Adam A. Dalia Edward A. Bittner Marvin G. Chang
author_facet	Rachel Steinhorn Adam A. Dalia Edward A. Bittner Marvin G. Chang
author_sort	Rachel Steinhorn
title	Surgical pulmonary embolectomy on VA-ECMO
title_short	Surgical pulmonary embolectomy on VA-ECMO
title_full	Surgical pulmonary embolectomy on VA-ECMO
title_fullStr	Surgical pulmonary embolectomy on VA-ECMO
title_full_unstemmed	Surgical pulmonary embolectomy on VA-ECMO
title_sort	surgical pulmonary embolectomy on va-ecmo
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/0cb562adcfb54ab7bf927c272f1cc4ca
work_keys_str_mv	AT rachelsteinhorn surgicalpulmonaryembolectomyonvaecmo AT adamadalia surgicalpulmonaryembolectomyonvaecmo AT edwardabittner surgicalpulmonaryembolectomyonvaecmo AT marvingchang surgicalpulmonaryembolectomyonvaecmo
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Surgical pulmonary embolectomy on VA-ECMO

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