Extracorporeal Membrane Oxygenation for Failed
TPA Therapy of Pulmonary Embolism
Volume 1 - Issue 4
Joshua Newman1,2, David Park1 and Frank Manetta1, 2*
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- 1Department of Cardiovascular and Thoracic Surgery, USA
- 2Department of Hofstra North Shore LIJ School of Medicine, Hofstra University, USA
*Corresponding author:
Frank Manetta, Department of Cardiovascular and Thoracic Surgery, North Shore University Hospital
Received: September 14, 2018; Published: September 21, 2018
DOI: 10.32474/ACR.2018.01.000116
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Abstract
Pulmonary embolism may cause cardiac arrest secondary to obstruction of blood flow. Traditional treatment strategies include
anticoagulation, thrombolysis, and mechanical extraction. Some advocate for support with extra corporeal membrane oxygenation
(ECMO); however, surgical therapies are contraindicated following thrombolytics. We describe the emergent use of peripheral
ECMO following thrombolytic therapy for a saddle pulmonary embolism associated with multiple episodes of cardiac arrest. The
patient was stabilized with peripheral ECMO, anticoagulated and subsequently weaned from ECMO without any major bleeding
complications. The administration of thrombolytics should not be a contraindication for ECMO in patients with massive pulmonary
embolism associated with hemodynamic instability.
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