Annals of Thoracic Medicine Official publication of the Saudi Thoracic Society, affiliated to King Saud University
 
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BRIEF REPORT
Year : 2012  |  Volume : 7  |  Issue : 3  |  Page : 157-161

Novel approach for the management of sub-massive pulmonary embolism


1 Division of Pulmonary Medicine, Riyadh Military Hospital, Riyadh, Saudi Arabia
2 Department of Cardiology, Prince Salman Heart Centre, King Fahad Medical City, Riyadh, Saudi Arabia

Correspondence Address:
Majdy M Idrees
President, Saudi Association for Pulmonary Hypertension (SAPH), Head, Pulmonary Vascular Unit, Division of Pulmonary Medicine, Riyadh Military Hospital, Riyadh
Saudi Arabia
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DOI: 10.4103/1817-1737.98850

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Background: Right ventricular (RV) dysfunction has been identified as a poor prognostic indicator in sub-massive pulmonary embolism (SPE). We hypothesized that using selective vasodilator agent is beneficial in improving RV function in patients with this condition. Methods: We used inhaled prostacyclin analogue (Iloprost, Ventavis®) in five patients with SPE. Helical computerized tomography angiogram was confirmatory for pulmonary embolism and echocardiography was used to evaluate the RV status. All patients received inhaled Iloprost, 2.5 to 5 μg every 4 hours for 3 weeks. Results: Patients were prospectively followed for 3 months. They were assessed at baseline before starting Iloprost treatment and at 3 days, 3 weeks, and 3 months after treatment. All patients showed significant improvement in their functional class, Borg dyspnea score, NT pro-BNP level, and echocardiographic parameters. Conclusion: In SPE, directing therapy toward decreasing pulmonary vascular resistance improves the associated pulmonary hemodynamic compromise and improves RV function.


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