Large pulmonary embolus without systemic hemodynamic consequences during cemented hip arthroplasty.
A case is presented in which a large embolus was detected passing through the right side of the heart during total hip arthroplasty. Although tricuspid regurgitation and an elevated right ventricular pressure resulted, there was no perturbation in systemic hemodynamics or gas exchange. The emboli detected during total hip arthroplasty are most likely composed of fat. No specific treatment is required, although heightened vigilance for disturbances in systemic hemodynamics is important.
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Department of Anaesthesia, Sunnybrook Health Science Centre and University of Toronto, Ontario, Canada.
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D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D001794:Blood Pressure / Q000502:physiology; D002484:Cementation; D015150:Echocardiography, Doppler; D017548:Echocardiography, Transesophageal; D004620:Embolism, Fat / Q000150:complications; D006339:Heart Rate / Q000502:physiology; D006439:Hemodynamics; D006801:Humans; D007431:Intraoperative Complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D010101:Oxygen Consumption / Q000502:physiology; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D011659:Pulmonary Gas Exchange / Q000502:physiology; D014262:Tricuspid Valve Insufficiency / Q000209:etiology; D018084:Ultrasonography, Interventional; D017725:Ventricular Pressure / Q000502:physiology