Acute massive pulmonary artery embolism after pulmonary resection is very rare, but has a high mortality rate. This is one of the most severe complications after pulmonary resection. Acute pulmonary artery embolism developed suddenly in a patient who underwent lobectomy and was recovering without complications. Because the patient's condition was aggravated after conservative treatment, we did emergency open embolectomy which was successful. Hence, we report this case with a literature review.
Embolectomy ; Embolism ; Emergencies ; Humans ; Pulmonary Artery

It is ironic that John Gibbon's interest in the development of CPB was stimulated by his experience with a fatal case of pulmonary embolism. Massive pulmonary embolism is a siginificant cause of death in hospital, despite improvement in patient management in recent years. In Korea, none of the reports was detailed the anesthetic management of this group of physiologically compromised patients. So we describe an approach to the anesthetic management of a patients with chronic embolic occlusion of the pulmonary artery, who underwent successful pulmonary embolectomy.
Cause of Death ; Embolectomy* ; Humans ; Iron ; Korea ; Pulmonary Artery ; Pulmonary Embolism

An acute thromboembolism of the peripheral artery is a common complication in patient with inappropriately treated atrial fibrillation. A case of successful recanalization of a thromboembolic occlusion of the left common femoral artery, using the PercuSurge GuardWire(TM) System, with a 7 Fr. guiding catheter, was experienced in a patient with atrial fibrillation.
Arteries ; Atrial Fibrillation ; Catheters* ; Embolectomy ; Femoral Artery* ; Humans ; Thromboembolism

The optimal treatment for free-floating massive right heart thrombi remains uncertain. However, they appear to increase the risk of mortality compared to the existence of a solitary pulmonary thromboembolism. Thrombolytic therapy has been shown to be effective in most patients, resulting in complete resolution of the massive thrombus and clinical improvement. We report the echocardiographic disappearance of a free-floating right heart thrombus after thrombolysis, however, the thrombus migrated and resulted in pulmonary thromboembolism. It was successfully removed with surgery.
Embolectomy ; Heart ; Humans ; Pulmonary Embolism ; Thrombolytic Therapy ; Thrombosis

We recently experienced self-detachment of the Solitaire stent during mechanical thrombectomy of acute ischemic stroke. Then, we tried to remove the detached stent and to recanalize the occlusion, but failed with endovascular means. The following diffusion weighted image MRI revealed no significant increase in infarction size, therefore, we performed surgical removal of the stent to rescue the patient and to elucidate the reason why the self-detachment occurred. Based upon the operative findings, the stent grabbed the main thrombi but inadvertently detached at a severely tortuous, acutely angled, and circumferentially calcified segment of the internal carotid artery. Postoperative angiography demonstrated complete recanalization of the internal carotid artery. The patient's neurological deficits gradually improved, and the modified Rankin scale score was 2 at three months after surgery. In the retrospective case review, bone window images of the baseline computed tomography (CT) scan corresponded to the operative findings. According to this finding, we hypothesized that bone window images of a baseline CT scan can play a role in terms of anticipating difficult stent retrieval before the procedure.
Angiography ; Carotid Artery, Internal ; Diffusion ; Embolectomy ; Humans ; Infarction ; Retrospective Studies ; Stents ; Stroke ; Thrombectomy

A 76-year-old woman with hypertension was admitted to the hospital with complaints of chest pain and dyspnea. An echocardiogram and pulmonary computed tomography angiography showed right atrial myxoma complicated with pulmonary thromboembolism. An operation to resect the right atrial myxoma and pulmonary embolism was recommended; however, the patient refused and was discharged with anticoagulation therapy. Two years later, she developed dyspnea. Radiological studies and echocardiography showed similar results with the previous findings. The patient underwent mediastinotomy with resection of the right atrial myxoma and pulmonary embolectomy. As there are few reports on right atrial myxoma complicated with pulmonary embolism, we report a successful case of surgical removal of right atrial myxoma and pulmonary embolism.
Angiography ; Chest Pain ; Dyspnea ; Echocardiography ; Embolectomy ; Female ; Heart Neoplasms ; Humans ; Hypertension ; Myxoma ; Pulmonary Embolism

We successfully managed one-lung ventilation in a 5-yr-old boy who underwent thoracoscopic removal of an emphysematosed right lower lobe. We used a 5-French 70 cm balloon-tipped Fogarty embolectomy catheter as a bronchial blocker. Its single lumen, which ends blindly, contains a guidewire and is used to inflate a spherical balloon. First, we threaded the distal end of the blocker through the Murphy hole of a 5.5 cuffed endotracheal tube. The tip of the blocker was adjusted to the end of the endotracheal tube, and the remainder of the blocker was attached closely to the outer wall of the tube and fixed once at the neck of the tube with tape. The tube and catheter were intubated as a set. After intubation, a bronchoscope was introduced through the tube. Under bronchoscopic view, Fogarty catheter was drawn back by 1 2 cm to withdraw the catheter tip from the Murphy hole and then advanced until the balloon tip reached the right main bronchus. With balloon inflation, we were able to achieve satisfactory one-lung ventilation.
Bronchi ; Bronchoscopes ; Catheters ; Embolectomy ; Humans ; Inflation, Economic ; Intubation ; Male ; Neck ; One-Lung Ventilation*

Lymphomatous involvement of the heart, occurring at initial diagnosis and presentation, is extremely rare. We report here a case of 58 year old man who presented with generalized edema, pericardial effusion, and a large right atrial mass detected by transesophageal echocardiography. There is no other evidence of disseminated lymphoma in this patient. Tumor removal and pulmonary embolectomy was done. Pathologically, the mass was malignant lymphoma, diffuse large cell type. Unfortunately, we have no chance to perform the intensive chemotherapy. The patient discharged in moribund state.
Diagnosis ; Drug Therapy ; Echocardiography, Transesophageal ; Edema ; Embolectomy ; Heart ; Humans ; Lymphoma* ; Middle Aged ; Pericardial Effusion

Acute massive pulmonary embolism after intracerebral hemorrhage (ICH) is rare but associated with a high mortality rate. A 44-year-old man presented with acute pulmonary embolism on 38th day after onset of ICH. We tried off-pump pulmonary embolectomy with CPB on stand-by. But, hemodynamic deterioration occurred when right pulmonary artery was clamped after removal of some clots, therefore CPB was rapidly instituted under normothermic beating heart with full heparinization. On pump beating, heart pulmonary embolectomy was performed successfully without adverse events. On postoperative 2nd day, the patient was started on anticoagulation therapy and recovered favorably without any neurologic sequelaes.
Adult ; Cerebral Hemorrhage ; Embolectomy ; Heart ; Hemodynamics ; Heparin ; Humans ; Pulmonary Artery ; Pulmonary Embolism

A 55-year-old man with massive pulmonary thromboembolism underwent thrombolysis, pulmonary artery embolectomy and tricuspid annuloplasty. Nine months later, a mobile echogenic intra-cardiac mass was found in the tricuspid valve. Because the patient had undergone annuloplasty, thrombosis was suspected as the most likely diagnosis and thrombolytic therapy was instituted. However, the size of the cardiac mass did not change and after surgical excision the mass was found to be a myxoma. Cardiac valvular tumors are uncommon and when they occur they are usually slow growing fibroelastomas. In this case, the rapid growing cardiac myxoma on the tricuspid valve was found after the occurrence of pulmonary thromboembolism. To our knowledge, this is first reported case of tricuspid valve myxoma in Korea.
Embolectomy ; Humans ; Korea ; Middle Aged ; Myxoma ; Pulmonary Artery ; Pulmonary Embolism ; Thrombolytic Therapy ; Thrombosis ; Tricuspid Valve