Zhu Guiwei, Yue Wenhui, Li Yanmin, Wang Haiqing, Li Jianqiang, Zhou Xin, Zhang Qinghai, Zhang Jihong
Department of Critical Care Medicine, Weifang People's Hospital, Weifang, Shandong.
Department of Hand and Foot Orthopedic Surgery, Weifang People's Hospital, Weifang, Shandong, China.
Front Med (Lausanne). 2025 Jan 29;12:1530566. doi: 10.3389/fmed.2025.1530566. eCollection 2025.
Acute aortic dissection (AAD) and pulmonary embolism (PE) are two critical and potentially fatal causes of chest pain. The simultaneous occurrence of these conditions is exceptionally rare; however, when they co-occur, the conflicting therapeutic strategies required significantly elevate mortality rates. While venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been extensively reported as a life-saving intervention for high-risk pulmonary embolism, its application in the management of AAD remains highly debated. Recently, our institution successfully employed VA-ECMO to treat a patient with acute type A aortic dissection (ATAAD) complicated by PE. This case highlights that VA-ECMO may serve as a crucial life-saving measure for patients with AAD who present with hemodynamic instability or cardiac arrest.
急性主动脉夹层（AAD）和肺栓塞（PE）是胸痛的两个关键且可能致命的病因。这些病症同时出现极为罕见；然而，当它们同时发生时，所需的相互冲突的治疗策略会显著提高死亡率。虽然静脉-动脉体外膜肺氧合（VA-ECMO）作为高危肺栓塞的挽救生命的干预措施已被广泛报道，但其在AAD治疗中的应用仍存在高度争议。最近，我们机构成功应用VA-ECMO治疗了一名合并PE的急性A型主动脉夹层（ATAAD）患者。该病例表明，VA-ECMO可能是出现血流动力学不稳定或心脏骤停的AAD患者的关键挽救生命措施。
