Postcesarean pulmonary embolism, sustained cardiopulmonary resuscitation, embolectomy, and near-death experience

Abstract

Background: Survival after surgical embolectomy for massive postcesarean pulmonary embolism causing sustained cardiac arrest is rare.

Case: One day after an uneventful cesarean delivery, a woman developed cardiac asystole and apnea due to pulmonary embolism. Femoral-femoral cardiopulmonary bypass performed during continuous cardiopulmonary resuscitation allowed a successful embolectomy. Upon awakening, the patient reported a near-death experience. Pulmonary embolism causes approximately 2 deaths per 100,000 live births per year in the United States, and postcesarean pulmonary embolism is probably more common than pulmonary embolism after vaginal delivery.

Conclusion: Massive pulmonary embolism is a potentially treatable catastrophic event after cesarean delivery, even if continuous cardiopulmonary resuscitation is required until life-saving embolectomy is done.