Beyond Clots: The Role of Cardiac Anesthesiologists in a Case of ECMO for Massive Pulmonary Embolism.

We present a case of a 35-year-old male who presented with sudden-onset severe chest pain and breathlessness. CTPA revealed massive bilateral pulmonary embolism. The patient underwent catheter-directed mechanical thrombectomy (CDMT) under general anesthesia, complicated by cardiogenic shock necessitating cardiopulmonary resuscitation (CPR). Post ROSC, venoarterial ECMO was initiated, and catheter-directed thrombolysis was performed. CDMT was reattempted but not fully successful, and the patient developed right heart failure with pulmonary hypertension. ECMO continued for 5 days and gradually weaned off. He was extubated successfully on Day 7 and discharged home later.