• Journal of Chest Surgery
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• v.43 no.4
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• pp.433-436
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• 2010

Acute massive pulmonary artery embolism after pulmonary resection is very rare, but has a high mortality rate. This is one of the most severe complications after pulmonary resection. Acute pulmonary artery embolism developed suddenly in a patient who underwent lobectomy and was recovering without complications. Because the patient’s condition was aggravated after conservative treatment, we did emergency open embolectomy which was successful. Hence, we report this case with a literature review.

• Journal of Chest Surgery
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• v.35 no.9
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• pp.684-687
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• 2002

Besides lung transplantation, pulmonary thromboembolectomy is the only effective therapeutic option for chronic thromboembolic pulmonary hypertension. It is however associated with a considerably high hospital mortality between 6.6 to 23%. Proper patient selection is critical when considering a patient for pulmonary thromboembolectomy. And It cannot be overemphasised that the key to the success of the operation is complete endarterectomy of the entire pulmonary arterial tree. We report that pulmonary thromboendarterectomy under total circulatory arrest was an effective and safe method in the surgical correction of the chronic thrornboernbolic pulmonary hypertension and enabled complete removal of superimposed peripheral organized thrombi in a good operative field.

• Journal of Chest Surgery
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• v.36 no.7
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• pp.531-534
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• 2003

A 43-year-old woman who had had an invasive mole 5 years previously required emergent pulmonary embolectomy under cardiopulmonary bypass. Curative resection was impossible because the tumor invaded the right main pulmonary artery and left lower pulmonary artery. The pathologic diagnosis made by the tumor emboli specimens was choriocarcinoma. The patient received post-operative chemotherapy over a 6-month period and had complete remission. Although rare, choriocarcinoma should be considered in the differential diagnosis of fertile women presented with pulmonary embolism.

• Journal of Chest Surgery
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• v.29 no.5
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• pp.569-572
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• 1996

A sixty nine-year-old mate patient was admitted with a chief complaint of exertional dyspnea. Lung perfusion scan revealed total perfusion defect of the of left lung and CT anglography showed the ab- rupt cutoff left pulmonary artery. He denied of trauma history, previous lower leg symptom and sign, or any embolic history. With the impression of chronic pulmonary thromboembolism of unknown etiology, operation was done under the cardiopulmonary bypass through a median sternotomy. After main pulmonary artery clamping and pulmonary arteriotomy, thromboembolectomy was done. Postoperative lung perfusion scan and CT angiography showed near normal left pulmonary blood flow. The patient was discharged on the postoperative 9th day without any postoperative complication.

• Journal of Chest Surgery
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• v.24 no.12
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• pp.1201-1208
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• 1991

Two successful pulmonary thromboendartectomies were performed. In the first case, it was performed under cardiopulmonary bypass with moderate hypothermia and ventricular fibrillation In the second case, it was done under deep hypothermia and intermittent circulatory arrest. The patients are recovered uneventfully without complication and discharged from the hospital on warfarin. Their symptoms were improved and the follow-up pulmonary perfusion scans revealed no evidence of residual pulmonary embolus in both cases.

• Journal of the Korean Society of Radiology
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• v.82 no.4
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• pp.1011-1017
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• 2021

Bone cement embolism often occurs during percutaneous vertebroplasty. Bone cement pulmonary arterial embolism generally requires no treatment because of the small size and asymptomatic manifestation. Intracardiac bone cement embolisms are rare but associated with a risk of severe complications. Intracardiac bone cement embolisms are mainly removed through open heart surgery. To the best of our knowledge, only three cases of intracardiac bone cement embolisms removed with interventions have been reported. Here, we report another case of successful transcatheter retrieval of a 6-cm-long cement embolism in the right atrium after percutaneous vertebroplasty. The embolus broke in half and migrated to the right pulmonary artery intraoperatively. Using two snares and a filter retrieval device, we advanced from opposite directions. Further, we gently grasped and pulled the fragments of the right pulmonary artery and aligned them in a linear fashion directly into the sheath for uneventful removal.

• Journal of Chest Surgery
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• v.40 no.12
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• pp.867-870
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• 2007

Antiphospholipid syndrome (APS) is defined as venous and/or arterial thromboses, recurrent fetal losses, thrombocytopenia in combination with repeatedly positive tests for the lupus anticoagulant (LAC), and anticardiolipin antibodies (aCL). The pulmonary manifestation is APS are relatively rare. We report a rare case of antiphopholipid syndrome with systemic lupus erythematosus in a patient who presented with pulmonary hypertension secondary to a chronic pulmonary thromboembolism. A bilateral thromboendarterectomy was performed satisfactorily and the incision was extended to the left intrapleural pulmonary artery.

• Tuberculosis and Respiratory Diseases
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• v.44 no.4
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• pp.889-898
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• 1997

Pulmonary Embolism can develop in variable conditions, and presents with nonspecific symptoms and signs. If diagnosis is delayed, it can be resulted in catastrophic results. Therefore, early diagnosis and adequate treatment is crucial in Pulmonary Embolism. Lung Perfusion Scan is useful screening test. Negative result can exclude pulmonary embolism. But, perfusion defects don't always mean pulmonary embolism. To find the better methods of interpretation of lung perfusion scan and To evaluate the clinical course and outcomes of the patients, in whom pulmonary embolism was suspected by lung perfusion scan, we reviewed the clinical records of 49 cases suspected by lung perfusion scan at Seoul National University Hospital during the period of January, 1995 to July, 1996. The results are as follows. First impression of cases in which PE was present at time of admission were pulmonary embolism (63%), heart diseases (26%), and pneumonia (11%) in orders. Underlying diseases of cases in which PE developed during admission were malignancy (36.5%), ICH (22.7%), sepsis (13.7%), and SLE (9.1%) in orders. The predisposing factors were operation (20%), cancer (16%), immobility (16%), connective tissue disease (16%), heart dis. (10%), old age (10%), and preg/pelvic dis. (8%) The results, of lung perfusion scan were HPPE 40 cases(26.8 %), IPPE 21 cases(14.1%), LPPE 88 cases (59.1%), and cases(%) of treatment in these cases were HPPE 34 cases(85%), IPPE 9 cases(42.9%), LPPE 0 case(0.0%). Treatments were heparin and warfarin (69.5%), heparin alone (8.2%), warfarin alone (2.0%), embolectomy (4.1%), thrombolytics (2.0%), IVC filter (2.0%), and no treatment (12.2%) In 34 cases (69.4%), follow up could be done, and 5 cases were recurred (10.2%). The causes of recurrence was incomplete anticoagulant therapy (3 cases) and recurrence of predisposing factor (2 cases). Expired case due to pulmonary embolism was one who was expired just before trial of thrombolytic therapy. Conclusion : Efforts should be made to shorten the interval from onset of Sx to Dx, ie, high index of suspision.

• Journal of Chest Surgery
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• v.42 no.4
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• pp.492-496
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• 2009

Background: The treatment of acute pulmonary embolism is difficult, and it can be lethal when cardiogenic shock is involved with major pulmonary embolism. In the past, pulmonary embolectomy was considered as the last choice for patients with pulmonary embolism. Accordingly, we analyzed our experience with seven cases of pulmonary embolectomy as an alternative option for the early treatment of pulmonary embolism. Material and Method: A retrospective analysis of medical charts of all patients who underwent pulmonary embolectomy at our hospital over the past eight years was performed. The patients were observed during their hospital stay and followed until their last visit to the outpatient department. Result: Among 7 patients (4 men and 3 women), 4 had massive pulmonary embolism, and 3 had sub massive pulmonary embolism. An extracorporeal membrane oxygenator was inserted in 3 patients before surgery. There was no mortality, and postoperative echocardiography showed no pulmonary hypertension in 6 patients. Conclusion: Pulmonary embolectomy can be performed with minimal mortality. We think that the use of an extracorporeal membrane oxygenator in patients with cardiogenic shock before surgery improves survival.