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Ann Thorac Surg 2002;73:1299-1301
© 2002 The Society of Thoracic Surgeons

Case report

Successful treatment of pulmonary hypertension with inhaled nitric oxide after pulmonary embolectomy

Georg Trummer, MD*a, Michael Berchtold-Herz, MDa, Jürgen Martin, MDa, Friedhelm Beyersdorf, MDa

a Department of Cardiovascular Surgery, Albert-Ludwigs-University Freiburg, Freiburg, Germany

Accepted for publication August 14, 2001.

* Address reprint requests to Dr Trummer, Department of Cardiovascular Surgery, Albert-Ludwigs-University Freiburg, Hugstetter Straße 55, D-79106 Freiburg, Germany
e-mail: georg_trummer{at}yahoo.com

Inhaled nitric oxide is an agent known to reduce pulmonary vascular resistance and prevent right heart failure. Pulmonary embolism is frequently followed by right heart failure and cardiogenic shock. Although successful treatment of patients with right ventricular failure caused by pulmonary embolism has been reported, clinical use of inhaled nitric oxide as an adjunct to surgical treatment is not in widespread use. We present a case of a 69-year-old woman with massive pulmonary embolism followed by right ventricular failure. After emergency operation, weaning from ventilation was prolonged. Pulmonary hypertension was decreased with low-dose inhaled nitric oxide, although pulmonary gas exchange did not improve. The patient was weaned successfully from ventilation 52 hours after operation and recovered completely. In a follow-up examination after 9 months, the patient is in healthy constitution with good cardiopulmonary function.






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