1/171. A successful case of pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension with a thrombus in the right ventricle.Chronic thromboembolism is a frequent cause of progressive hypertension and carries a poor prognosis. Medical treatment is not effective and surgery provides the only potential for a cure at present. We herein report a successful case of thromboendarterectomy treated via a median sternotomy with intermittent circulatory arrest. A 43-year-old man was admitted to our hospital complaining of progressive dyspnea, edema of the lower extremities, and a fever with an unknown origin. A subsequent definitive evaluation showed him to be suffering from surgically accessible chronic thromboembolic pulmonary hypertension with a thrombus in the right ventricle. He underwent a pulmonary thromboendarterectomy and thrombectomy via a median sternotomy with intermittent circulatory arrest on November 24, 1994. Postoperatively he showed a marked improvement in his hemodynamic status and blood gas analysis. He has also returned to work with no trouble. Deep vein thrombosis appeared to be the pathogenesis of this case, but we could not find the origin of his unknown fever. He is currently being controlled by treatment with methylprednisolone as before.- - - - - - - - - - ranking = 1keywords = thromboembolism, embolism (Clic here for more details about this article) |
2/171. Witnessed embolization of a right atrial mass during transesophageal echocardiography: implications regarding the safety of esophageal intubation.A patient with chronic lung disease and a right atrial density that was difficult to distinguish on a transthoracic echocardiogram underwent transesophageal echocardiography (TEE) that demonstrated two mobile masses attached to the anterior right atrial wall. During the TEE procedure, the patient experienced coughing and retching due to the esophageal intubation, and the embolization of one of the right atrial masses was observed. This case is the first to document this mechanism of pulmonary embolism (a mechanism that was suspected in two prior reports), and it questions the safety of procedures that induce retching and coughing in patients with mobile right atrial masses.- - - - - - - - - - ranking = 0.65878950817071keywords = pulmonary embolism, embolism (Clic here for more details about this article) |
3/171. Formation of a left atrial ball thrombus from a large mural thrombus 4 days after an embolic episode.We present a case of basilar artery embolism originating from a left atrial mural thrombus. The thrombus was large and attached to the posterior left atrial wall, but decreased in size and detached forming a ball type thrombus over the next 4 days without anticoagulant and/or antifibrinolytic therapy.- - - - - - - - - - ranking = 0.067919097533245keywords = embolism (Clic here for more details about this article) |
4/171. Right heart thrombus: the importance of early intervention.A case report of mobile, right heart thrombus in the accident and emergency (A&E) department is presented. Though frequently associated with major pulmonary embolism, recognition is usually at postmortem examination. Detection of the presence of mobile thrombus in the right heart by early echocardiogram and prompt treatment may be life saving. Surgical or medical treatment options are dependent on local facilities. Early specialist involvement with a contingency plan in A&E departments are advised.- - - - - - - - - - ranking = 0.65878950817071keywords = pulmonary embolism, embolism (Clic here for more details about this article) |
5/171. thromboembolism in the right side of the heart.Right-sided cardiac thromboemboli, or pulmonary emboli-in-transit, represent an unusual disease process with high morbidity and mortality. We present a detailed case report and a synopsis of our experience at the University of mississippi Medical Center between 1990 and 1997 and review the current medical literature. These thrombi and emboli may largely be subdivided into type A--a mobile, serpiginous clot that is probably a mobilized deep vein thrombus--and type B--a rather immobile clot morphologically similar to left-sided heart thrombi that may represent intracardiac thrombosis. The mainstays of therapy include surgical embolectomy and thrombolysis, but there is no clear benefit of one over the other. Treatment should be individualized according to the clot's size and morphology, likelihood of preexisting pulmonary embolism, the patient's cardiopulmonary reserve, comorbid conditions, and local expertise with treatment modalities.- - - - - - - - - - ranking = 0.93046589830369keywords = pulmonary embolism, embolism (Clic here for more details about this article) |
6/171. Central venous catheter mechanical irritation of the right atrial free Wall:A cause for thrombus formation.thromboembolism is a major complication of long-term central venous catheter, usually associated with catheter or venous occlusion. Intracavitary right atrial thrombosis is currently considered to result from line-tip thrombosis extension. We report three adult patients in whom repeated mechanical trauma to the right atrial wall was probably the main mechanism. Transesophageal echocardiography revealed back and forth movement of the central catheter into a thrombus attached to the right atrial wall, thus suggesting a mechanism of catheter-associated thrombus formation, not previously visualized or suggested. Catheter removal and anticoagulation administration were undertaken with an uneventful clinical course and almost complete disappearance of the thrombi on transesophageal echocardiography follow-up.- - - - - - - - - - ranking = 0.067919097533245keywords = embolism (Clic here for more details about this article) |
7/171. When the body and appendage of the left atrium disagree: "Focal" atrial fibrillation-implications for atrial thrombus formation and risk of thromboembolism.A case is presented of a man who had 5 hours of atrial fibrillation followed by spontaneous conversion and maintained sinus rhythm that persisted as shown by surface electrocardiography. Transesophageal echocardiography performed 24 hours after electrocardiographic conversion documented an atrial fibrillation pattern within the left atrial appendage, with a normal sinus Doppler pattern in the body of the left atrium. This apparent regional discrepancy in atrial function may partially explain the increased risk for "late" thromboembolism among patients with atrial fibrillation who appear to be successfully converted with sustained sinus rhythm.- - - - - - - - - - ranking = 5keywords = thromboembolism, embolism (Clic here for more details about this article) |
8/171. Favorable outcome in a large left heart air embolism: lessons from an unusual complication of a noninvasive chest scan.OBJECTIVE: To report an unusual life-threatening complication of the performance of a computed tomographic (CT) scan of the chest. DESIGN: Case report. SETTING: University hospital. PATIENT: An intubated patient with blunt thoracic trauma. INTERVENTION: Performance of a CT scan of the chest at full inspiration. MAIN RESULT: With air insufflation, a large left ventricular air embolism occurred as a consequence of an airway breach, revealed by the simultaneous existence of a mild bilateral anterior pneumothorax. CONCLUSION: CT scan of the chest in patients at risk of airway breach (patients with acute respiratory distress syndrome, trauma patients) should first be performed at full expiration, not full inspiration.- - - - - - - - - - ranking = 0.33959548766623keywords = embolism (Clic here for more details about this article) |
9/171. Ventricular thrombosis and systemic embolism in bodybuilders: etiology and management.Increased thrombogenicity and acute embolism are well-recognized complications of chronic anabolic steroid abuse. The following cases highlight such dangers in steroid-enhanced bodybuilders who developed intracardiac thrombosis that subsequently embolized. Systemic anticoagulation and surgical thrombectomy constituted the mainstay treatment. This represents the first report of such devastating cardiovascular complications after anabolic steroid abuse and their management.- - - - - - - - - - ranking = 0.33959548766623keywords = embolism (Clic here for more details about this article) |
10/171. A case of confirmed nonbacterial thrombotic endocarditis with correlative transesophageal echocardiographic findings.The diagnosis of nonbacterial thrombotic endocarditis is rarely made during life. We describe a patient with non-Hodgkin's lymphoma with evidence of systemic embolism in which transesophageal echocardiography was useful in establishing the diagnosis. The clinical and echocardiographic features of nonbacterial thrombotic endocarditis should be remembered when a valvular mass is seen on echocardiography.- - - - - - - - - - ranking = 0.067919097533245keywords = embolism (Clic here for more details about this article) |
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