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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...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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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 |
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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 |
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