[Emergency Pulmonary Embolectomy with Combined Use of Retrograde Pulmonary Perfusion for Massive Pulmonary Thromboembolism:Report of a Case].

Massive pulmonary embolism is a life-threatening disease, which requires early intensive care. Surgical pulmonary embolectomy is a last resort for patients with hemodynamic instability. We report the case of an emergency pulmonary embolectomy with using retrograde pulmonary perfusion (RPP) for massive pulmonary thromboembolism. The patient is a 54-year-old male who was admitted to neurosurgical department for brain infarction. Due to his immobility, he developed deep vein thrombosis in the right superficial femoral vein and then, suddenly collapsed with chest pain. While we prepared for introduction of extracorporeal membrane oxygenation, he was resuscitated and diagnosed with massive pulmonary embolism on pulmonary arterial angiography. Emergency pulmonary embolectomy with using RPP was successfully performed. Postoperative course is uneventful except that he had percutaneous tracheostomy in postoperative day 11. We did not detect residual clots in bilateral pulmonary arteries. After 73 days of hospitalization, he was discharged from hospital. As this novel surgical approach has been rarely reported in Japan, we reviewed all three cases from Japan.