Tromboendarterectomía:Presentación de un caso

When conventional treatment for pulmonary thromboembolism is unsuccessful, a therapeutic alternative is thromboendarterectomy. Here we report a 19 years old girl who began with pain and edema in the right leg, followed 15 days later by sudden thoracic pain, syncope and dyspnea, which motivated her hospital admission. The chest x-rays and the ECG were normal, but the perfusion lung scan showed absence of perfusion in almost all the entire right lung, which was corroborated by digital substraction angiography. The pulmonary vessels pressure was normal. There was no immunologic abnormality or blood dyscrasia. Treatment with heparin and thrombolytic and coumarin agents was started, but due to the few response and the risk posed by the thrombus, a thromboendarterectomy was performed, obtaining a yellowish, hard thrombus. The evolution was