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PubMed2002

Successful treatment of pulmonary hypertension with inhaled nitric oxide after pulmonary embolectomy.

Inhaled nitric oxide is an agent known to reduce pulmonary vascular resistance and prevent right heart failure. Pulmonary embolism is frequently followed by right heart failure and cardiogenic shock. Although successful treatment of patients with right ventricular failure caused by pulmonary embolism has been reported, clinical use of inhaled nitric oxide as an adjunct to surgical treatment is not in widespread use. We present a case of a 69-year-old woman with massive pulmonary embolism followed by right ventricular failure. After emergency operation, weaning from ventilation was prolonged. Pulmonary hypertension was decreased with low-dose inhaled nitric oxide, although pulmonary gas exchange did not improve. The patient was weaned successfully from ventilation 52 hours after operation and recovered completely. In a follow-up examination after 9 months, the patient is in healthy constitution with good cardiopulmonary function.

Administration, Inhalation↗
PubMed1982

Transvenous vena caval filtration and pulmonary embolectomy.

The diagnosis of deep vein thrombosis or pulmonary embolism can be made accurately using angiographic and radioisotopic techniques. Utilizing hemodynamic data, it is possible to classify patients with pulmonary embolism into five groups, which is helpful for planning therapy and assessing prognosis. Surgery for pulmonary embolism has evolved to include intraluminal methods of vena caval filtration for prevention of recurrent pulmonary embolism and transvenous extraction of pulmonary emboli. Though the majority of patients surviving pulmonary embolism can be managed medically with anticoagulation, a significant number will require surgical intervention. The development of transvenous methods allows effective emergency management of major pulmonary embolism, even in hospitals that do not have the capability for cardiopulmonary bypass.

Blood↗