AW: [HSF] Pulmonary embolism-RV dysfunction

[Dr. Roberto Battellini]

I am with you, Ani.
Roberto

-----Ursprüngliche Nachricht-----
Von: openheart-l-bounces at lists.hsforum.com
[mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von Ani Anyanwu
Gesendet: Donnerstag, 2. August 2007 12:28
An: openheart-l at lists.hsforum.com
Betreff: RE: [HSF] Pulmonary embolism-RV dysfunction

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.> >
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