Fataler Verlauf nach erfolgreicher pulmonaler Endarteriektomie – der seltene Fall

Zusammenfassung

Wir berichten über eine 43-jährige Frau, die sich nach stattgehabten rezidivierenden Lungenarterienembolien mit Entwicklung einer chronischen thromboembolischen pulmonalen Hypertonie einer primär erfolgreichen pulmonalen Endarteriektomie unterzog. Zwei Jahre später, nach stattgehabter SARS-CoV-2-Infektion und trotz konsequent eingenommener oraler Antikoagulation, wurde die Patientin erneut vorstellig mit klinischen Zeichen einer Lungenarterienembolie, die sich bildgebend als fulminante Lungenarterienembolie darstellte. Trotz medikamentöser Fibrinolysetherapie und dem Versuch einer interventionellen Thrombusaspiration gelang es nicht, die große Embolielast zu beherrschen, sodass die Patientin bedauerlicherweise verstarb.

Abstract

We report a case of a 43-year-old woman who suffered from recurrent pulmonary embolism leading to chronic thromboembolic pulmonary hypertension. Pulmonary endarterectomy was performed with good result. However, two years later, after a SARS-CoV2 infection and despite oral anticoagulation therapy, the patient presented with clinical symptoms of pulmonary embolism, which was confirmed by computed tomography as an extensive pulmonary embolism. Despite fibrinolysis therapy and the attempt of interventional thrombus aspiration, the patient died due to non-manageable embolism load.

Schlüsselwörter

Lungenarterienembolie - pulmonale Hypertonie - pulmonale Enderteriektomie - SARS-CoV-2

Keywords

pulmonary embolism - pulmonary hypertension - pulmonary endarterectomy - SARS-CoV-2

Publication History

Received: 16 June 2023

Accepted after revision: 28 August 2023

Article published online:
19 October 2023

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