Chronic cor pulmonale and refractory hypoxemia following pulmonary embolism in a six-month-old neonate: surgical treatment via thromboendarterectomy.

A diagnosis of pulmonary embolism is uncommon in the infant and the child, and chronic cor pulmonale secondary to pulmonary embolism is an even rarer occurrence. Case report - in this study a case of pulmonary embolism in a 6-month-old m ale infant has been reported. His past history included preterm birth, and severe bronchopulmonary dysplasia, with prolonged oxygen dependency: The po sitive diagnosis was based on cardiac ultrasound examination, with the dire ct imaging of a right pulmonary arterial thrombus. Surgical thromboendarter ectomy was performed, with a long-term favorable outcome. Conclusion, - After excluding from the diagnosis those hemostatic disorders known to be thrombogenic, the most likely hypothesis was retained, i.e., t hat if was catheter-related. A central venous catheter had been inserted du ring the neonatal period, and was probably responsible for the embolism. Th e clinical characteristics and the diagnostic and therapeutic aspects of ch ronic postembolic cor pulmonale have been discussed in the light of the pre sent findings. (C) 2000 Editions scientifiques et medicales Elsevier SAS.