1/92. An unusual iatrogenic cause of right coronary air embolism.A 62-year-old woman undergoing redo mitral valve replacement was noted to have persistent intracardiac air following standard deairing procedures. Transesophageal echocardiography (TEE) identified air bubbles entering the left atrium from the right superior pulmonary vein. Exploration of the pleural cavity revealed a fistula between the pulmonary parenchyma and the right superior pulmonary vein caused by the atriotomy closure suture transfixing the edge of the lung, which was repaired with immediate disappearance of the air emboli. This demonstrates that transesophageal echocardiography is an invaluable aid to ensuring complete deairing after open heart procedures.- - - - - - - - - - ranking = 1keywords = embolism, air embolism, air (Clic here for more details about this article) |
2/92. pulmonary embolism due to right ventricular thrombus in a case of Behcet's disease.Right ventricular thrombus is a very rare manifestation of cardiovascular Behcet's disease. A 25-year-old man was admitted to hospital due to cough and fever of unknown origin. He experienced repetitive pulmonary embolism due to a right ventricular thrombus, which was surgically removed. A diagnosis of Behcet's disease was made based on his clinical course and the histological findings of the right ventricular wall and the skin lesion. He was quickly relieved of his symptoms after warfarinization and cyclosporine therapy.- - - - - - - - - - ranking = 1.1804838217664keywords = embolism (Clic here for more details about this article) |
3/92. death during percutaneous transluminal coronary angioplasty (PTCA) and the medicolegal aspects.Coronary embolisation is a very rare complication of the clinically widespread method of percutaneous transluminal coronary angioplasty (PTCA). The well-documented case of a 64-year-old male patient is presented comparing angiographic and morphological findings. The occluded left anterior descending artery (LAD) was successfully dilated during PTCA. Simultaneously the circumflex artery showed acute occlusion. The patient fell into cardiac shock and died after attempted resuscitation and agonal installation of extracorporeal circulation. The autopsy revealed severe residual stenosis of the proximal LAD by parietal thrombosis and occlusion of the proximal circumflex artery by an unattached intraluminal thrombus (0.8 x 0.3 x 0.2 cm) which had been dislocated during PTCA. autopsy thus confirmed the clinical presumption of coronary embolism and, in addition, disclosed a previously unknown perforation of the femoral artery which had occurred during agonal installation of extracorporeal circulation and contributed to death via severe retroperitoneal hemorrhage. The case is discussed under the aspects of clinical quality control by forensic pathological investigations.- - - - - - - - - - ranking = 0.23609676435328keywords = embolism (Clic here for more details about this article) |
4/92. Postoperative right atrial and pulmonary embolism after prolonged spinal surgery.Perioperative pulmonary thromboembolism can proceed rapidly with grave prognosis, in which immediate or accurate diagnosis and management is not easy. According to the literatures, patients receiving spinal surgery are at relatively lower risk of developing thromboembolism. We would like to present a case of postoperative pulmonary thromboembolism which developed after a prolonged lumbar spinal surgery. tachycardia and unstable hemodynamics were noted postoperatively. Pulmonary and right atrial thrombi were disclosed by transesophageal echocardiography. Although cardiotomy and thrombectomy were immediately performed, the patient finally died 3 days after the operation. The pathogenesis of venous thromboembolism (VTE) in the surgical patients, the risk factors which predispose a patient to VTE, diagnosis, and treatment as well as the prophylactic measures of VTE are herein reviewed and discussed.- - - - - - - - - - ranking = 1.8887741148262keywords = embolism (Clic here for more details about this article) |
5/92. Fatal myocardial embolus after myectomy.Coronary embolism is an infrequent phenomenon. A 56-year-old man with hypertrophic obstructive cardiomyopathy and severe mitral regurgitation who underwent left ventricular septal myectomy and mitral valve annular repair is presented. The patient had a cardiac arrest 36 h after surgery. Cardiac standstill, tamponade and a left ventricular rupture were noted when the chest was opened during attempted resuscitation. autopsy revealed an occlusive embolus of myocardium in the proximal left anterior descending coronary artery. It showed pathological features of hypertrophic cardiomyopathy. There was an extensive acute transmural anteroseptal left ventricular myocardial infarction with rupture of the anterior free wall. Embolism of myocardium - to the coronary arteries, the systemic circulation or the pulmonary circulation - is a rare event, with only nine other cases reported in the literature in the past 30 years. This is the first reported case of myocardial embolus to a coronary artery in a patient with hypertrophic obstructive cardiomyopathy following septal myectomy.- - - - - - - - - - ranking = 0.23651842864173keywords = embolism, air (Clic here for more details about this article) |
6/92. pulmonary embolism and intracardiac thrombi--individual therapeutic procedures.Mobile right heart thrombus is a severe but rare presentation of thromboembolic disease and usually coexists with an already massive pulmonary embolism (PE). But looking at the literature there is no clear consensus on therapeutic management. We therefore tried to find possible therapeutic guidelines and to evaluate an optimal diagnostic procedure looking at three patients who presented at our department with mobile right heart thrombus in the last year. The first patient with a small (diameter = 1 cm) thrombus in the right ventricle and peripheral pulmonary embolism underwent successful thrombolytic therapy without any complications. patients II and III showed large intracardiac masses, in patient III extending into the superior vena cava, with central PE. These two patients underwent pulmonary arteriotomy. The diagnostic line in each case was transthoracal echocardiography followed by a helix lung CT scan. Only patients with small intracardiac thrombi and thrombotic masses in the peripheral pulmonary arteries but with hemodynamically significant PE should be treated with thrombolytic agents.- - - - - - - - - - ranking = 1.4165805861197keywords = embolism (Clic here for more details about this article) |
7/92. Coronary air embolism treated by bubble aspiration.We describe a case of coronary air embolism following cardiac catheterization, with all the signs and symptoms of an acute coronary event. Thanks to the rapid and effective aspiration of the air bubble from the distal artery, blood flow was restored and the clinical picture was resolved.- - - - - - - - - - ranking = 1.2472591821251keywords = embolism, air embolism, air (Clic here for more details about this article) |
8/92. Surgical repair of right-atrial aneurysm.atrial fibrillation and embolic events are the most common clinical symptoms of congenital right- or left-atrial aneurysms. We report an a case of righ-atrial aneurysm, in a patient with typical history of atrial fibrillation and history of stroke. The aneurysm was resected, but the patient suffered from acute embolic occlusion of the left anterior descending coronary artery on the fourth postoperative day despite of systemic heparinization with 300 IU/kg bw per 24 hours.- - - - - - - - - - ranking = 0.0016866571537971keywords = air (Clic here for more details about this article) |
9/92. Fatal left main coronary artery embolism from aortic valve endocarditis following cardiac catheterization.Coronary artery embolization has been associated with sudden cardiac death. It is more commonly seen with aortic valve endocarditis. It manifests as acute myocardial ischemia or infarction, causing instability of the cardiac rhythm, which may be fatal. We report a patient with aortic valve endocarditis who had sudden cardiac death following coronary angiography. autopsy revealed embolic occlusion of the left main coronary artery.- - - - - - - - - - ranking = 0.94438705741312keywords = embolism (Clic here for more details about this article) |
10/92. Paradoxical embolism-report of a case involving four organ systems.Paradoxical embolism through a patent foramen ovale (PFO) can involve multiple organs simultaneously. The most commonly involved sites are the cerebrum and the extremities. Paradoxical embolism to coronary arteries or upper extremities is relatively uncommon. We report a case of acute pulmonary embolism and paradoxical embolism through a patent foramen ovale involving the left upper extremity, brain, and coronary artery. early diagnosis in the emergency department was made by a trans-esophageal echocardiogram, and the patient was successfully treated with intravenous t-PA and heparin. patients with acute pulmonary embolism or deep venous thrombosis who also develop signs of systemic embolism should be evaluated for a patent foramen ovale.- - - - - - - - - - ranking = 2.3609676435328keywords = embolism (Clic here for more details about this article) |
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