2015 Volume 24 Issue 5 Pages 827-831
A 68-year-old woman was urgently transported to the hospital due to a chief complaint of difficulty in breathing. On admission, she was found to have circulatory and respiratory failure. Based on the contrast computed tomography (CT) findings, we diagnosed the patient with acute pulmonary thromboembolism. Because of the difficulty of thrombus suction using an emergency catheter, a percutaneous cardiopulmonary support (PCPS) system was introduced and thrombolytic therapy was initiated. However, immediately after the setting of the PCPS system, continuous bleeding was observed at the cannulation site. A large volume of blood transfusion was needed to maintain the flow rate of PCPS. However, the circulatory and respiratory failures had worsened, and developed a bleeding tendency. On hospital admission day 2, by contrast CT pulmonary thrombus remained in the right main pulmonary artery, and therefore, a surgical procedure was considered to be necessary. Thus, the patient successfully underwent pulmonary thrombectomy using PCPS without a routine cardiopulmonary bypass to avoid further bleeding complications. The PCPS was withdrawn in the operating room at the same time. On postoperative day 15, the patient was successfully weaned from the ventilator. She was discharged well on postoperative day 45.
