Acute massive pulmonary embolism detected with angiography and intravascular ultrasound treated by pulmonary embolectomy. The hybrid concept.
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Development of a paradoxical embolus to the carotid circulation through a patent foramen ovale is uncommon but well documented. Previous surgical experience with this entity is limited. Treatment for this condition typically involves anticoagulation or the use of an inferior vena cava filter with concurrent closure of the patent foramen itself. We report successful surgical treatment of a woman with a paradoxical embolus lodged in her left carotid artery. In addition, we provide a brief review of this rare topic and treatment rationale.
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The purpose of this study was introduction and evaluation of efficacy and safety of retrograde thromboembolectomy in acute massive pulmonary emboli. The method is described in a 56-year-old woman with acute massive pulmonary thromboemboli. Postoperative course was uneventful. The described surgical technique is not a panacea and definitely not the whole answer, but is a big part of the solution and may be accompanied with less adverse effects. Additionally, there is a need of being reviewed further in large experimental studies and measurements before it could be used safely as a new technique.
A 60-year-old man experienced catastrophic haemodynamic decompensation 3 days following coronary artery bypass grafting (CABG). Aspiration thrombectomy to remove a left main coronary artery saddle embolus resulted in immediate haemodynamic improvement with no requirement for angioplasty or repeat bypass grafting. Coronary thromboembolism should be considered in the differential diagnosis of haemodynamic collapse post CABG. Urgent coronary angiography and aspiration thrombectomy may result in significant improvement for this condition.
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Single-lung transplantation for pulmonary hypertension results in a significant ventilation/perfusion mismatch with dramatic shift of blood flow, but not ventilation, to the replacement organ. This raises concern that the patient may be precariously dependent on the function of the transplanted lung. We report the successful management of a massive central pulmonary embolus to the transplanted lung in a 43-year-old woman 4 years after single-lung transplantation for primary pulmonary hypertension.