Abstract
A 73-year-old woman underwent laparoscopic bilateral adrenalectomy for bilateral adrenal tumors. On postoperative day 2, she complained of respiratory distress while getting out of bed and suffered cardiopulmonary arrest. The clinical course and laboratory tests suggested acute pulmonary embolism. Percutaneous cardiopulmonary support (PCPS) was started, followed by pulmonary arteriography, which showed complete occlusion of the right pulmonary artery by a massive embolism and an embolus in the left pulmonary artery. The diagnosis was acute pulmonary embolism.
A surgical pulmonary artery embolectomy was performed under PCPS rather than using a pump oxygenator to avoid bleeding complications on day 2 after adrenalectomy. The patient's hospital course was prolonged because of postoperative complications including adrenal insufficiency and pneumonia. However, there were no neurological sequelae, and on day 100, the patient was transferred to a rehabilitation facility.
This case demonstrates that surgical pulmonary artery embolectomy under PCPS can be effective in patients with a high risk of bleeding complications.
