Division of Cardiac Surgery, University of Rochester Medical Center, Rochester, NY, USA.
Eur J Cardiothorac Surg. 2021 May 8;59(5):1126-1127. doi: 10.1093/ejcts/ezaa380.
We present a complicated case of massive pulmonary embolism occurring 11 weeks after a craniotomy in a patient with multiple high-risk comorbidities. The patient underwent successful pulmonary artery surgical embolectomy via left mini-thoracotomy incision on peripheral venoarterial extracorporeal membrane oxygenation support. For this patient, avoiding a sternotomy allowed for greatly decreased postoperative morbidity and the use of venoarterial extracorporeal membrane oxygenation allowed for the avoidance of intraoperative anticoagulation. This case demonstrates the feasibility of off-pump surgical pulmonary embolectomy via left mini-thoracotomy as a treatment strategy for appropriate patients to improve patient-centred care.
我们报告了一例复杂的病例，一名患有多种高危合并症的患者在开颅手术后 11 周发生了大面积肺栓塞。患者在体外膜肺氧合支持下，经左侧小开胸切口成功进行了肺动脉外科取栓术。对于该患者，避免正中开胸可显著降低术后发病率，使用体外膜肺氧合可避免术中抗凝。该病例表明，经左侧小开胸非体外循环手术取栓术作为一种治疗策略，对合适的患者是可行的，可改善以患者为中心的护理。
