{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T20:56:30Z","timestamp":1762980990763,"version":"3.37.3"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:00:00Z","timestamp":1596240000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Massive pulmonary embolism (PE) with shock constitutes a life-threatening disease, challenging physicians with the need for fast decision-making in an emergency situation. While thrombolytic treatment or thrombectomy are considered the treatment of choice in high-risk PE, these strategies might not be able to unload the right ventricle (RV) fast enough in some patients with severe cardiogenic shock.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>We present a case of a patient with massive bilateral central PE who presented in cardiogenic shock, rapidly deteriorating to cardiac arrest. After successful re-establishing spontaneous circulation, the patient remained highly unstable, necessitating a treatment strategy ensuring a quick stabilization of the circulation. Therefore, we decided to use veno-arterial extracorporeal membrane oxygenation (vaECMO) as a supportive strategy allowing for autolysis of the lung to dissolve the thrombi (bridge to recovery). We were able to wean the patient from vaECMO support within 4 days and documented a complete recovery of right ventricular in echocardiography before hospital discharge.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>The concept of vaECMO treatment alone might be a valuable alternative in selected patients with massive PE and cardiogenic shock, in whom thrombolytic therapy might not unload the RV fast enough.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaa168","type":"journal-article","created":{"date-parts":[[2020,8,4]],"date-time":"2020-08-04T03:00:58Z","timestamp":1596510058000},"page":"1-6","source":"Crossref","is-referenced-by-count":3,"title":["Massive pulmonary embolism with intra-hospital cardiac arrest and full recovery of right ventricular function after veno-arterial extracorporeal membrane oxygenation therapy: a case report"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0224-9208","authenticated-orcid":false,"given":"Stephan","family":"Camen","sequence":"first","affiliation":[{"name":"Clinic for Cardiology, University Heart and Vascular Center Hamburg, Building O70, Martinistrasse 52, 20246 Hamburg, Germany"},{"name":"DZHK (German Center for Cardiovascular Research), partner site Hamburg\/Kiel\/L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerold","family":"S\u00f6ffker","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, University Hospital Hamburg-Eppendorf, Martinistra\u00dfe 52, 20246 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Kluge","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, University Hospital Hamburg-Eppendorf, Martinistra\u00dfe 52, 20246 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elvin","family":"Zengin","sequence":"additional","affiliation":[{"name":"Clinic for Cardiology, University Heart and Vascular Center Hamburg, Building O70, Martinistrasse 52, 20246 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,8,3]]},"reference":[{"key":"2020101507250894100_ytaa168-B1","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1160\/TH07-03-0212","article-title":"Venous thromboembolism (VTE) in Europe. The number of VTE events and associated morbidity and mortality","volume":"98","author":"Cohen","year":"2007","journal-title":"Thromb Haemost"},{"key":"2020101507250894100_ytaa168-B2","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1093\/eurheartj\/ehz405","article-title":"2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS)","volume":"41","author":"Konstantinides","year":"2020","journal-title":"Eur Heart J"},{"key":"2020101507250894100_ytaa168-B3","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1177\/0267659119830014","article-title":"Extracorporeal membrane oxygenation in life-threatening massive pulmonary embolism","volume":"34","author":"Kjaergaard","year":"2019","journal-title":"Perfusion"},{"key":"2020101507250894100_ytaa168-B4","doi-asserted-by":"crossref","first-page":"4196","DOI":"10.1093\/eurheartj\/ehy464","article-title":"Outcomes after extracorporeal membrane oxygenation for the treatment of high-risk pulmonary embolism: a multicentre series of 52 cases","volume":"39","author":"Meneveau","year":"2018","journal-title":"Eur Heart J"},{"key":"2020101507250894100_ytaa168-B5","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1177\/0267659118786830","article-title":"Extracorporeal membrane oxygenation in acute massive pulmonary embolism: a case series and review of the literature","volume":"34","author":"Al-Bawardy","year":"2019","journal-title":"Perfusion"},{"key":"2020101507250894100_ytaa168-B6","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1186\/s13054-017-1655-8","article-title":"Life-threatening massive pulmonary embolism rescued by venoarterial-extracorporeal membrane oxygenation","volume":"21","author":"Corsi","year":"2017","journal-title":"Crit Care"},{"key":"2020101507250894100_ytaa168-B7","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1177\/0267659114524264","article-title":"Evaluation of the activated clotting time and activated partial thromboplastin time for the monitoring of heparin in adult extracorporeal membrane oxygenation patients","volume":"29","author":"Atallah","year":"2014","journal-title":"Perfusion"},{"key":"2020101507250894100_ytaa168-B8","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1016\/S0735-1097(98)00068-0","article-title":"Comparative efficacy of a two-hour regimen of streptokinase versus alteplase in acute massive pulmonary embolism: immediate clinical and hemodynamic outcome and one-year follow-up","volume":"31","author":"Meneveau","year":"1998","journal-title":"J Am Coll Cardiol"},{"key":"2020101507250894100_ytaa168-B9","doi-asserted-by":"crossref","first-page":"1536","DOI":"10.1016\/j.jacc.2016.12.039","article-title":"Impact of thrombolytic therapy on the long-term outcome of intermediate-risk pulmonary embolism","volume":"69","author":"Konstantinides","year":"2017","journal-title":"J Am Coll Cardiol"},{"key":"2020101507250894100_ytaa168-B10","doi-asserted-by":"crossref","first-page":"I22","DOI":"10.1161\/01.CIR.0000078464.82671.78","article-title":"Natural history of venous thromboembolism","volume":"107","author":"Kearon","year":"2003","journal-title":"Circulation"},{"key":"2020101507250894100_ytaa168-B11","doi-asserted-by":"crossref","first-page":"1263","DOI":"10.2214\/AJR.09.3410","article-title":"Resolution of pulmonary embolism on CT pulmonary angiography","volume":"194","author":"Stein","year":"2010","journal-title":"AJR Am J Roentgenol"},{"key":"2020101507250894100_ytaa168-B12","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.athoracsur.2012.03.052","article-title":"Peripheral extracorporeal membrane oxygenation: comprehensive therapy for high-risk massive pulmonary embolism","volume":"94","author":"Malekan","year":"2012","journal-title":"Ann Thorac Surg"},{"key":"2020101507250894100_ytaa168-B13","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1111\/jth.13175","article-title":"Derivation of a clinical prediction score for chronic thromboembolic pulmonary hypertension after acute pulmonary embolism","volume":"14","author":"Klok","year":"2016","journal-title":"J Thromb Haemost"},{"key":"2020101507250894100_ytaa168-B14","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1177\/1358863X18824650","article-title":"National trends and outcomes for extra-corporeal membrane oxygenation use in high-risk pulmonary embolism","volume":"24","author":"Elbadawi","year":"2019","journal-title":"Vasc Med"},{"key":"2020101507250894100_ytaa168-B15","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1097\/MAT.0000000000000475","article-title":"Extracorporeal life support organization registry international report 2016","volume":"63","author":"Thiagarajan","year":"2017","journal-title":"ASAIO J"}],"container-title":["European Heart Journal - 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