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Am Rev Respir Dis. 1993 Jun;147(6 Pt 1):1595-7.

Thrombolysis for life-threatening pulmonary embolism 2 days after lung resection.

Author information

1
Department of Thoracic Surgery, Centre M├ędico-Chirurgical de la Porte de Choisy, Paris, France.

Abstract

Early postoperative severe pulmonary embolism is usually considered an indication for surgical embolectomy because thrombolytic agents cannot be used. Severe pulmonary embolism was diagnosed 2 days after lung resection in two patients, including one with hypercapnia during spontaneous breathing, perhaps a unique feature of massive embolism on a single lung. Although emergency surgical embolectomy was available, both patients were given a bolus infusion of thrombolytic agents, with an immediate (within 1 h) clinical and hemodynamic improvement and a favorable outcome despite delayed major bleeding in one patient. The reported data and an analysis of the available literature support the view that recent surgery should be considered a relative rather than absolute contraindication to thrombolysis and that decision making in this setting should be based on a careful case-by-case evaluation of the expected benefits and risks of the various available treatments.

PMID:
8503574
DOI:
10.1164/ajrccm/147.6_Pt_1.1595
[Indexed for MEDLINE]

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