Successful surgical management of massive pulmonary embolism during the second trimester in a parturient with heparin-induced thrombocytopenia.
Summary of "Successful surgical management of massive pulmonary embolism during the second trimester in a parturient with heparin-induced thrombocytopenia."
Cardiopulmonary bypass during pregnancy is associated with a high fetal and maternal mortality. We report a successful pulmonary embolectomy in a woman at the 27th week of pregnancy; we performed surgical pulmonary embolectomy under cardiopulmonary bypass to restore adequate hemodynamic and to relieve right ventricle strain. We discuss the decision made for the preferred anticoagulation drug in the setting of heparin-induced thrombocytopenia in the gravida. The pregnancy was carried to term and she delivered a healthy boy at 38 weeks of gestation. Keywords: Pregnancy; Pulmonary thromboembolism; Cardiopulmonary bypass; Heparin-induced thrombocytopenia.
Affiliation
Cardio-thoracic Surgery, CHU Poitiers, 2 rue de la Milétrie, 86021 Poitiers, France.
Journal Details
This article was published in the following journal.
Name: Interactive cardiovascular and thoracic surgery
ISSN: 1569-9285
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20729238
- DOI: http://dx.doi.org/10.1510/icvts.2010.247460
Medical and Biotech [MESH] Definitions
Pulmonary Heart Disease
Hypertrophy and dilation of the RIGHT VENTRICLE of the heart that is caused by PULMONARY HYPERTENSION. This condition is often associated with pulmonary parenchymal or vascular diseases, such as CHRONIC OBSTRUCTIVE PULMONARY DISEASE and PULMONARY EMBOLISM.
Pulmonary Embolism
Blocking of the PULMONARY ARTERY or one of its branches by an EMBOLUS.
Warfarin
An anticoagulant that acts by inhibiting the synthesis of vitamin K-dependent coagulation factors. Warfarin is indicated for the prophylaxis and/or treatment of venous thrombosis and its extension, pulmonary embolism, and atrial fibrillation with embolization. It is also used as an adjunct in the prophylaxis of systemic embolism after myocardial infarction. Warfarin is also used as a rodenticide.
Acute Chest Syndrome
Respiratory syndrome characterized by the appearance of a new pulmonary infiltrate on chest x-ray, accompanied by symptoms of fever, cough, chest pain, tachypnea, or DYSPNEA, often seen in patients with SICKLE CELL ANEMIA. Multiple factors (e.g., infection, and pulmonary FAT EMBOLISM) may contribute to the development of the syndrome.
Embolism, Air
Blocking of a blood vessel by air bubbles that enter the circulatory system, usually after TRAUMA; surgical procedures, or changes in atmospheric pressure.
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