Surgical Embolectomy for Acute Massive Pulmonary Thromboembolism Requiring Percutaneous Cardiopulmonary Support after Thoracoabdominal Aorta Replacement

A 48-year-old man was admitted to our hospital and underwent thoracoabdominal aorta replacement. Eight days postoperatively, he developed severe dyspnea and transient drop in blood pressure suddenly following walk rehabilitation. Contrast-enhanced computed tomography showed thrombi in the bilateral main pulmonary artery. Respiratory failure and unstable hemodynamics developed, which required percutaneous cardiopulmonary support (PCPS). Because catheter embolectomy and thrombolytic therapy via pulmonary artery catheter were not effective, surgical thrombectomy was performed. PCPS was successfully removed on the following day. The patient was extubated on postoperative day 10 and discharged without complications on day 46 following rehabilitation. It is important to save a critically ill patient with acute pulmonary embolism requiring PCPS, and surgical treatment should be performed without delay in such patients.