Korean J Anesthesiol.  2004 Sep;47(3):429-432. 10.4097/kjae.2004.47.3.429.

Therapy of Pulmonary Embolism under Cardiopulmonary Bypass during Bipolar Endoprosthesis of the Hip

• Oh IY
• Cho JH
• Kim YJ
• Cho CK
• Choi HY
• Park CK

• KMID: 2299116
• DOI: http://doi.org/10.4097/kjae.2004.47.3.429

Abstract

Although the occurrence of fatal pulmonary embolism may be diminishing, it still accounts for a substantial proportion of postoperative deaths in the middle-aged and older persons, especially among those undergoing major orthopedic surgery, despite improvements in patient management. We experienced cardiac arrest during bipolar endoprosthesis. Cardiopulmonary resuscitation was started and the transesophageal echocardiogram showed right heart failure. We suspected acute pulmonary thromboembolism and decided to perform thromboembolectomy with cardiopulmonary bypass. A massive old blood clot and a 1.0 x 1.5 cm thrombus were removed from both pulmonary arteries. However, despite massive fluid therapy and the use of inotropic agent, the patient failed to recover successfully with postoperative management in the intensive care unit.

Keyword

cardiac arrest; orthopedic-bipolar endoprosthesis; pulmonary embolism

MeSH Terms

Cardiopulmonary Bypass*
Cardiopulmonary Resuscitation
Fluid Therapy
Heart Arrest
Heart Failure
Hip*
Humans
Intensive Care Units
Orthopedics
Pulmonary Artery
Pulmonary Embolism*
Thrombosis