A Case of Chronic Pulmonary Embolism Successfully Treated by Thrombectomy
A 48 - year-old female complained of dyspnea and frontal chest pain five days after surgery for uterine cancer. The diagnosis was acute pulmonary embolism and she was treated with fibrinolytic therapy. Although the pulmonary embolism was reduced and hypoxemia was improved, there was still an unresolved pulmonary thrombus and pulmonary hypertension. Therefore, a cardiopulmonary bypass was performed under moderate hypothermia and without aortic cross-clamping. An organizing thrombus was revealed in the bilateral pulmonary arteries distal to and across from the mediastinal pleura, and a thrombectomy was performed. The postoperative course was uneventful. Postoperative pulmonary arteriography revealed some residual thrombus, and improvement of pulmonary hypertension was noted on right heart catheterization.