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Hiroki Sakai
Iizuka Hospital, Japan
ScientificTracks Abstracts: Gen Surg: Open Access
A 46-year-old obese woman undergoing treatment for bipolar disorder presented with acute shortness of breath, chest pain, and palpitations. She was tachypnea and tachycardia, but blood pressure was stable. Computed tomography angiogram revealed bilateral pulmonary embolism. Echocardiogram revealed thrombus in transit. She underwent surgical embolectomy only for thrombus-in-transit and closure of the Patent Foramen Ovale (PFO). However, pulmonary hypertension worsened, hemodynamical instability prolonged and hepatic congestion progressed. After Veno-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO) insertion, we performed thrombectomy by catheter and anticoagulation therapy. One month later, the patient was transferred to another hospital for rehabilitation. Recent Publications 1. D. S. Hui, F. Fleischman and P. M. McFadden. Thromboembolism-in-transit and patent foramen ovale: Should screening echocardiogram be routine for thromboembolic disease? Ochsner J 2016;16:321-3. 2. V. S. Ellensen, S. Saeed, T. Geisner and R. Haaverstad. Management of thromboembolism-in-transit with pulmonary embolism. Echo Res Pract 2017;4:K47-k51. 3. S. I. Lee, Y. J. Kim, K. Y. Park and C. H. Park. Rapid evaluation of acute pulmonary embolism with thromboembolism-in-transit. J Card Surg 2019;34:202-04. 4. W. T. Kuo, M. K. Gould, J. D. Louie, J. K. Rosenberg, D. Y. Sze and L. V. Hofmann. Catheter-directed therapy for the treatment of massive pulmonary embolism: Systematic review and meta-analysis of modern techniques. J Vasc Interv Radiol 2009;20:1431-40. 5. H. Tajima, S. Murata, T. Kumazaki, K. Nakazawa, H. Kawamata, T. Fukunaga et al. Manual aspiration thrombectomy with a standard ptca guiding catheter for treatment of acute massive pulmonary thromboembolism. Radiat Med 2004;22:168-72. 6. T. Schmitz-Rode, U. Janssens, S. H. Duda, C. M. Erley and R. W. Günther. Massive pulmonary embolism: Percutaneous emergency treatment by pigtail rotation catheter. J Am Coll Cardiol 2000;36:375-80. 7. T. Tu, C. Toma, V. F. Tapson, C. Adams, W. A. Jaber, M. Silver et al. A prospective, single-arm, multicenter trial of catheter-directed mechanical thrombectomy for intermediate-risk acute pulmonary embolism: The flare study. JACC Cardiovasc Interv 2019;12:859-69.
Hiroki Sakai is a surgeon, specialist on cardiothoracic surgery at Iizuka Hospital, Japan.
