Fatal pulmonary hemorrhagic infarction caused by pulmonary vein thrombotic occlusion during venoarterial extracorporeal membrane oxygenation

Kohei Masaki, Toru Hashimoto, Masato Katsuki, Kisho Ohtani, Taiki Higo, Tomoki Ushijima, Yoshihisa Tanoue, Akira Shiose, Hiroyuki Tsutsui

研究成果: Contribution to journalArticle査読

抄録

A 20-year-old man with arrhythmogenic right ventricular cardiomyopathy (ARVC) was resuscitated from ventricular fibrillation. He was transferred to our hospital because of progressive multiorgan dysfunction despite mechanical circulatory support with peripheral venoarterial extracorporeal membrane oxygenation (VA-ECMO) and intra-aortic balloon pump (IABP). At admission to our hospital, chest X-ray showed bilateral complete lung opacification, and echocardiography revealed a massive thrombus occupying the left atrium (LA) and left ventricle (LV). Conversion to central ECMO with transapical LV venting and thrombectomy were performed. The huge LA thrombus occluded all pulmonary veins (PVs). Despite the surgery and intensive care, complete lung opacity remained, and he died of multiorgan failure associated with sepsis. Autopsy demonstrated bilateral pulmonary multiple red infarctions, and histopathology showed alveolar wall necrosis with extensive hemorrhage, confirming a diagnosis of pulmonary hemorrhagic infarction. Extensive pulmonary infarction was attributable to PV occlusion due to massive LA thrombus. PV thrombosis should be considered when refractory lung opacities are encountered during VA-ECMO and necessitates early intervention.

本文言語英語
ページ(範囲)1182-1185
ページ数4
ジャーナルInternational heart journal
62
5
DOI
出版ステータス出版済み - 2021

All Science Journal Classification (ASJC) codes

  • 循環器および心血管医学

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