THROMBECTOMY OF THE RIGHT PULMONARY ARTERY AFTER MASSIVE PE IN THE EARLY POSTOPERATIVE PERIOD IN A PATIENT WITH MICSCABG: A CASE REPORT

Highlights

Pulmonary embolism is a life–threatening complication caused by surgery on the heart and blood vessels. This case report describes a case of a 60-year-old patient diagnosed with pulmonary artery thrombosis after minimally invasive multiple coronary artery bypass grafting according to MSCT angiography. Thrombectomy of the right pulmonary artery was performed with cardiopulmonary bypass and Calafiore cardioplegia along with thrombectomy of the common femoral, common iliac and large subcutaneous veins on the left, and crossectomy. Constant monitoring, stabilization and improvement of the patient's condition demonstrated the effectiveness of the selected diagnostic method and treatment strategy.

Abstract

Massive pulmonary embolism (PE) is a serious life-threatening complication in the postoperative period of cardiovascular surgery. This case describes the treatment strategy in a 60-year-old patient after minimally invasive multiple coronary artery bypass grafting. The massive PE that occurred in the postoperative period required simultaneous open surgery – thrombectomy of the right pulmonary artery with cardiopulmonary bypass and thrombectomy of the vena femoralis communis (VFC), vena saphena magna (VSM), and crossectomy. One-stage approach is justified in order to reduce the risk of recurrent PE, pulmonary hypertension and right ventricular failure in the long-term period. This clinical case demonstrates successful one-stage surgical treatment of massive PE using two different vessels after minimally invasive cardiac surgery - multiple coronary artery bypass grafting (MICSCABG).

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