Saddle pulmonary embolus resulting in cardiovascular collapse requiring extracorporeal membrane oxygenation in a postoperative patient with endometrial cancer
Background: Venous thromboembolism after open gynecologic surgery is not uncommon, especially in the presence of other risk factors such as obesity, prolonged surgical time or gynecologic malignancy. Case: We present the case of a 62 y.o. patient who underwent open hysterectomy and surgical staging...
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doaj-205fea86505242ee8c71dc4152f6243a2020-11-24T22:02:17ZengElsevierGynecologic Oncology Reports2352-57892018-05-01243638Saddle pulmonary embolus resulting in cardiovascular collapse requiring extracorporeal membrane oxygenation in a postoperative patient with endometrial cancerDavid Samuel0Gregory M. Gressel1Sara Isani2Akiva P. Novetsky3Nicole S. Nevadunsky4Montefiore Medical Center and Albert Einstein College of Medicine, Department of Obstetrics & Gynecology and Women's Health, 1825 Eastchester Road, Room 722. Bronx, NY 10463, United StatesMontefiore Medical Center and Albert Einstein College of Medicine, Department of Obstetrics & Gynecology and Women's Health, 1825 Eastchester Road, Room 722. Bronx, NY 10463, United States; Albert Einstein Cancer Center, Albert Einstein College of Medicine, Bronx, NY, United States; Corresponding author at: 3332 Rochambeau Ave, Bronx, New York 10467, United States.Montefiore Medical Center and Albert Einstein College of Medicine, Department of Obstetrics & Gynecology and Women's Health, 1825 Eastchester Road, Room 722. Bronx, NY 10463, United States; Albert Einstein Cancer Center, Albert Einstein College of Medicine, Bronx, NY, United StatesMontefiore Medical Center and Albert Einstein College of Medicine, Department of Obstetrics & Gynecology and Women's Health, 1825 Eastchester Road, Room 722. Bronx, NY 10463, United States; Albert Einstein Cancer Center, Albert Einstein College of Medicine, Bronx, NY, United StatesMontefiore Medical Center and Albert Einstein College of Medicine, Department of Obstetrics & Gynecology and Women's Health, 1825 Eastchester Road, Room 722. Bronx, NY 10463, United States; Albert Einstein Cancer Center, Albert Einstein College of Medicine, Bronx, NY, United StatesBackground: Venous thromboembolism after open gynecologic surgery is not uncommon, especially in the presence of other risk factors such as obesity, prolonged surgical time or gynecologic malignancy. Case: We present the case of a 62 y.o. patient who underwent open hysterectomy and surgical staging for uterine serous carcinoma. She was readmitted with lower extremity edema. During her workup, she underwent cardiovascular arrest secondary to saddle pulmonary embolus requiring cardiopulmonary resuscitation and extracorporeal membrane oxygenation. After systemic and catheter directed thrombolysis, and a long hospitalization, she was discharged home in stable condition. Conclusion: Saddle pulmonary embolus is a potentially catastrophic and fatal postoperative complication. This case demonstrates a successful implementation of directed thrombolysis, veno-arterial extracorporeal membrane oxygenation and multidisciplinary management in a case of postoperative saddle pulmonary embolus. Précis: We report a case of an endometrial cancer patient who sustained a massive postoperative pulmonary embolus and was successfully resuscitated using extracorporeal membrane oxygenation. Keywords: Pulmonary embolus, Extracorporeal membrane oxygenation, Thrombolysis, Endometrial cancerhttp://www.sciencedirect.com/science/article/pii/S2352578918300225 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
David Samuel Gregory M. Gressel Sara Isani Akiva P. Novetsky Nicole S. Nevadunsky |
spellingShingle |
David Samuel Gregory M. Gressel Sara Isani Akiva P. Novetsky Nicole S. Nevadunsky Saddle pulmonary embolus resulting in cardiovascular collapse requiring extracorporeal membrane oxygenation in a postoperative patient with endometrial cancer Gynecologic Oncology Reports |
author_facet |
David Samuel Gregory M. Gressel Sara Isani Akiva P. Novetsky Nicole S. Nevadunsky |
author_sort |
David Samuel |
title |
Saddle pulmonary embolus resulting in cardiovascular collapse requiring extracorporeal membrane oxygenation in a postoperative patient with endometrial cancer |
title_short |
Saddle pulmonary embolus resulting in cardiovascular collapse requiring extracorporeal membrane oxygenation in a postoperative patient with endometrial cancer |
title_full |
Saddle pulmonary embolus resulting in cardiovascular collapse requiring extracorporeal membrane oxygenation in a postoperative patient with endometrial cancer |
title_fullStr |
Saddle pulmonary embolus resulting in cardiovascular collapse requiring extracorporeal membrane oxygenation in a postoperative patient with endometrial cancer |
title_full_unstemmed |
Saddle pulmonary embolus resulting in cardiovascular collapse requiring extracorporeal membrane oxygenation in a postoperative patient with endometrial cancer |
title_sort |
saddle pulmonary embolus resulting in cardiovascular collapse requiring extracorporeal membrane oxygenation in a postoperative patient with endometrial cancer |
publisher |
Elsevier |
series |
Gynecologic Oncology Reports |
issn |
2352-5789 |
publishDate |
2018-05-01 |
description |
Background: Venous thromboembolism after open gynecologic surgery is not uncommon, especially in the presence of other risk factors such as obesity, prolonged surgical time or gynecologic malignancy. Case: We present the case of a 62 y.o. patient who underwent open hysterectomy and surgical staging for uterine serous carcinoma. She was readmitted with lower extremity edema. During her workup, she underwent cardiovascular arrest secondary to saddle pulmonary embolus requiring cardiopulmonary resuscitation and extracorporeal membrane oxygenation. After systemic and catheter directed thrombolysis, and a long hospitalization, she was discharged home in stable condition. Conclusion: Saddle pulmonary embolus is a potentially catastrophic and fatal postoperative complication. This case demonstrates a successful implementation of directed thrombolysis, veno-arterial extracorporeal membrane oxygenation and multidisciplinary management in a case of postoperative saddle pulmonary embolus. Précis: We report a case of an endometrial cancer patient who sustained a massive postoperative pulmonary embolus and was successfully resuscitated using extracorporeal membrane oxygenation. Keywords: Pulmonary embolus, Extracorporeal membrane oxygenation, Thrombolysis, Endometrial cancer |
url |
http://www.sciencedirect.com/science/article/pii/S2352578918300225 |
work_keys_str_mv |
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