Bridging to a delayed pulmonary endarterectomy in massive acute-on-chronic pulmonary thromboembolism: a case report.

ABSTRACT:

Background

Rarely, the first sign of chronic thromboembolic pulmonary hypertension (CTEPH) is acute embolism, an acute-on-chronic event. These patients are challenging: they need emergent care but are not candidates for immediate definitive treatment with pulmonary endarterectomy (PEA) due to their critical condition.

Case presentation

We report a patient with massive acute-on-chronic pulmonary thromboembolism leading to cardiogenic shock. We decided on a staged surgical treatment strategy: emergency surgical embolectomy; brindging and stabilization with central veno-arterial extracorporeal membrane oxygenator; and delayed PEA. The patient had full recovery.

Conclusions

Patients with an undiagnosed CTEPH developing an acute embolism are in a very high risk of facing a

SUBMITTER: Lehtinen ML 

PROVIDER: S-EPMC12553231 | biostudies-literature | 2025 Oct

REPOSITORIES: biostudies-literature