Acute Management of Infected Chronic Thromboembolic Disease

Publication date: Available online 5 May 2018 Source:The Annals of Thoracic Surgery Author(s): Donna May Kimmaliardjuk, Carole Dennie, Sean Dickie, Eric C. Belanger, Fraser Rubens A 29-year-old male with chronic pulmonary emboli presented to hospital with progressive pleuritic chest pain. He was in acute right ventricular failure, and thus underwent intra-pulmonary arterial tissue plasminogen (tPA). He developed massive hemoptysis requiring emergent thromboendarterectomy. A clot was visualized in the main left pulmonary artery which had formed a bronchovascular fistula into the left upper lobe bronchus. Pathology of the clot revealed fibrinopurulent exudate and Gram-positive cocci. The left pulmonary artery was repaired with a pericardial patch, and the left upper lobe was oversewn with subsequent left upper lobectomy. The patient was discharged home on post-operative day 23.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research