Successful Surgical Pulmonary Embolectomy for Massive Perinatal Embolism after Emergency Cesarean Section

Ann Vasc Surg. 2015 Oct;29(7):1452.e1-4. doi: 10.1016/j.avsg.2015.04.066. Epub 2015 Jun 26.

Abstract

Pregnant women are exposed to an increased risk for developing pulmonary embolism (PE), a main cause for maternal mortality. Surgical pulmonary embolectomy is one important therapeutic and potential life-saving armamentarium, considering pregnancy as a relative contraindication for thrombolysis. We present a case of a 36-year-old woman with massive bilateral PE after emergent caesarean delivery, requiring reanimation by external heart massage. The onset of massive intrauterine bleeding contraindicated thrombolysis and emergency surgical pulmonary embolectomy, followed by a hysterectomy, were preformed successfully. Acute surgical pulmonary embolectomy may be an option in critically diseased high-risk patients, requiring a multiteam approach, and should be part of the therapeutic armamentarium of the attending cardiac surgeon.

MeSH terms

  • Adult
  • Cesarean Section / adverse effects*
  • Echocardiography, Transesophageal
  • Embolectomy*
  • Emergencies
  • Female
  • Heart Massage
  • Humans
  • Hysterectomy
  • Postpartum Hemorrhage / etiology
  • Postpartum Hemorrhage / surgery
  • Pregnancy
  • Pulmonary Embolism / diagnosis
  • Pulmonary Embolism / etiology
  • Pulmonary Embolism / surgery*
  • Risk Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome