Cargando…

Surgical Treatment in a High-Risk Pulmonary Embolism: Case Report

We present the case of a 35-year-old woman who had a high-risk pulmonary embolism (according to ESC risk stratification for pulmonary embolism) after she had undergone a Caesarion section. Postoperatively, she presented with acute left lower limb pain, swelling and erythema. A diagnosis was made of...

Descripción completa

Detalles Bibliográficos
Autores principales: Moldovan, Horatiu, Sibisan, Andra-Madalina, Tiganasu, Robert, Nechifor, Elena, Gheorghita, Daniela, Zaharia, Ondin, Albu, Mihai, Popescu, Daniela, Molnar, Adrian, Craciun, Mihaela, Scafa, Alexandru
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8305998/
https://www.ncbi.nlm.nih.gov/pubmed/34357006
http://dx.doi.org/10.3390/medicina57070725
_version_ 1783727704542019584
author Moldovan, Horatiu
Sibisan, Andra-Madalina
Tiganasu, Robert
Nechifor, Elena
Gheorghita, Daniela
Zaharia, Ondin
Albu, Mihai
Popescu, Daniela
Molnar, Adrian
Craciun, Mihaela
Scafa, Alexandru
author_facet Moldovan, Horatiu
Sibisan, Andra-Madalina
Tiganasu, Robert
Nechifor, Elena
Gheorghita, Daniela
Zaharia, Ondin
Albu, Mihai
Popescu, Daniela
Molnar, Adrian
Craciun, Mihaela
Scafa, Alexandru
author_sort Moldovan, Horatiu
collection PubMed
description We present the case of a 35-year-old woman who had a high-risk pulmonary embolism (according to ESC risk stratification for pulmonary embolism) after she had undergone a Caesarion section. Postoperatively, she presented with acute left lower limb pain, swelling and erythema. A diagnosis was made of deep vein thrombosis (DVT) of the ilio-femoral and popliteal veins. She was started on anticoagulant therapy, which proved to be inefficient, the patient developing a left calf and thigh oedema and shortness of breath. A CT scan revealed high-risk embolus located in the right atrium and through the tricuspid valve. The decision was made to refer her to a cardiovascular surgeon. During her preoperative evaluation, the patient became hemodynamically unstable and was rushed into the operating room, severely desaturated, bradycardic, without consciousness, with severe hypotension. On the basis of the severe state of the patient and the CT scan findings we performed an emergency pulmonary embolectomy, with the patient on cardio-pulmonary by-pass, without cross-clamping the aorta, using a modified Trendelenburg procedure. This case supports using open pulmonary embolectomy for patients with hemodynamic instability on the basis of clinical diagnosis.
format Online
Article
Text
id pubmed-8305998
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-83059982021-07-25 Surgical Treatment in a High-Risk Pulmonary Embolism: Case Report Moldovan, Horatiu Sibisan, Andra-Madalina Tiganasu, Robert Nechifor, Elena Gheorghita, Daniela Zaharia, Ondin Albu, Mihai Popescu, Daniela Molnar, Adrian Craciun, Mihaela Scafa, Alexandru Medicina (Kaunas) Case Report We present the case of a 35-year-old woman who had a high-risk pulmonary embolism (according to ESC risk stratification for pulmonary embolism) after she had undergone a Caesarion section. Postoperatively, she presented with acute left lower limb pain, swelling and erythema. A diagnosis was made of deep vein thrombosis (DVT) of the ilio-femoral and popliteal veins. She was started on anticoagulant therapy, which proved to be inefficient, the patient developing a left calf and thigh oedema and shortness of breath. A CT scan revealed high-risk embolus located in the right atrium and through the tricuspid valve. The decision was made to refer her to a cardiovascular surgeon. During her preoperative evaluation, the patient became hemodynamically unstable and was rushed into the operating room, severely desaturated, bradycardic, without consciousness, with severe hypotension. On the basis of the severe state of the patient and the CT scan findings we performed an emergency pulmonary embolectomy, with the patient on cardio-pulmonary by-pass, without cross-clamping the aorta, using a modified Trendelenburg procedure. This case supports using open pulmonary embolectomy for patients with hemodynamic instability on the basis of clinical diagnosis. MDPI 2021-07-17 /pmc/articles/PMC8305998/ /pubmed/34357006 http://dx.doi.org/10.3390/medicina57070725 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Moldovan, Horatiu
Sibisan, Andra-Madalina
Tiganasu, Robert
Nechifor, Elena
Gheorghita, Daniela
Zaharia, Ondin
Albu, Mihai
Popescu, Daniela
Molnar, Adrian
Craciun, Mihaela
Scafa, Alexandru
Surgical Treatment in a High-Risk Pulmonary Embolism: Case Report
title Surgical Treatment in a High-Risk Pulmonary Embolism: Case Report
title_full Surgical Treatment in a High-Risk Pulmonary Embolism: Case Report
title_fullStr Surgical Treatment in a High-Risk Pulmonary Embolism: Case Report
title_full_unstemmed Surgical Treatment in a High-Risk Pulmonary Embolism: Case Report
title_short Surgical Treatment in a High-Risk Pulmonary Embolism: Case Report
title_sort surgical treatment in a high-risk pulmonary embolism: case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8305998/
https://www.ncbi.nlm.nih.gov/pubmed/34357006
http://dx.doi.org/10.3390/medicina57070725
work_keys_str_mv AT moldovanhoratiu surgicaltreatmentinahighriskpulmonaryembolismcasereport
AT sibisanandramadalina surgicaltreatmentinahighriskpulmonaryembolismcasereport
AT tiganasurobert surgicaltreatmentinahighriskpulmonaryembolismcasereport
AT nechiforelena surgicaltreatmentinahighriskpulmonaryembolismcasereport
AT gheorghitadaniela surgicaltreatmentinahighriskpulmonaryembolismcasereport
AT zahariaondin surgicaltreatmentinahighriskpulmonaryembolismcasereport
AT albumihai surgicaltreatmentinahighriskpulmonaryembolismcasereport
AT popescudaniela surgicaltreatmentinahighriskpulmonaryembolismcasereport
AT molnaradrian surgicaltreatmentinahighriskpulmonaryembolismcasereport
AT craciunmihaela surgicaltreatmentinahighriskpulmonaryembolismcasereport
AT scafaalexandru surgicaltreatmentinahighriskpulmonaryembolismcasereport