[HSF] Pulmonary embolism-RV dysfunction

[Ani Anyanwu]

Read paper in circulation by Aklog et al from Brigham (I think also a recent update in Annals by Byrne et al). If this patient has emboli in the main PAs with RV dysfunction then that would be regarded as an indication for surgery. She is very young and summation of literature suggests presence of RV dysfunction is a risk factor for mortality. Filter will be placed via RA at time of surgery so will not dislodge groin thrombi. Leaving her PA full of clot - if she survives - sets her up for chronic thromboembolic disease.
 
Ani



> Date: Thu, 2 Aug 2007 19:42:42 +1000> From: chanju at gmail.com> To: OpenHeart-L at lists.hsforum.com> Subject: Re: [HSF] Pulmonary embolism-RV dysfunction> CC: > > Hi Dr Del,> > Need more information - what is the degree of RV dysfunction? CVP, PA> pressures, echo?> > In my opinion (which is very junior), she should be offered an IVC> filter and anticoagulation, but in the absence of major haemodynamic> compromise would not offer embolectomy.> > She should also be screened for procoagulable states-protein C, S,> factor V leiden, antithrombin III etc> > I would be interested to hear how you proceed.> > Regards,> Justin> > > On 8/2/07, yadav del <yadavluck at yahoo.com> wrote:> >> >> > 25 yrs old female developed pulmonary embolism on 2 nd post op day after repair of incisional hernia. CT scan showed emboli at both hila .Only left lower lobe artery is spared from emboli. Duplex scan showed bilateral ilio- femoral dvt. She iss haemodynamically stable. Saturation 94% with out oxygen and 98% on 2litres oxygen. Echo showed RV dysfunction.> >> > Should she be offered pulmonary embolectomy in view of RV dysfunction ?> >> >> > ---------------------------------> > Moody friends. Drama queens. Your life? Nope! - their life, your story.> > Play Sims Stories at Yahoo! Games.> > _______________________________________________> > OpenHeart-L mailing list> >> > Send postings to:> > OpenHeart-L at lists.hsforum.com> >> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:> > http://mmp.cjp.com/mailman/listinfo/openheart-l> >> > All messages transmitted by the OpenHeart-L are subject to the policies and> > disclaimers posted at:> > http://www.hsforum.com/listdisclaim> > -----------------------------------------> >> _______________________________________________> OpenHeart-L mailing list> > Send postings to:> OpenHeart-L at lists.hsforum.com> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:> http://mmp.cjp.com/mailman/listinfo/openheart-l> > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at:> http://www.hsforum.com/listdisclaim> -----------------------------------------
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