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Management of Peripheral Pulmonary Emboli with the Use of Transvenous Catheter‐ D irected Thrombolysis and Right Ventricular Assist Device
Author(s) -
Said Sameh M.,
Salhab Khaled F.,
Joyce Lyle D.
Publication year - 2013
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.12185
Subject(s) - medicine , thrombolysis , pulmonary embolism , embolectomy , peripheral , catheter , hemodynamics , cardiology , pulmonary artery , surgery , myocardial infarction
Objectives Pulmonary emboli (PE) can result in significant hemodynamic instability that requires urgent intervention; however, the management of peripheral emboli has been controversial. Patients and Methods We present two patients in whom a right ventricular assist device (RVAD) was used in treating peripheral pulmonary embolism, applying the technique of pulmonary artery catheter‐directed thrombolysis after resuscitation with an RVAD. Results The clot burden was not suitable for surgical embolectomy due to its peripheral locations. The patients' hemodynamic conditions improved with thrombolytic therapy and gradually were weaned off the RVAD. Follow‐up scans showed near resolution of all PE. Conclusion Catheter‐directed thrombolysis with an RVAD as an adjunct should be considered in management of peripheral PE. doi: 10.1111/jocs.12185 (J Card Surg 2013;28:611–615)