Intraoperative TEE monitoring on pulmonary thromboembolectomy--a case report.
We present a successful thromboembolectomy under intraoperative transesophageal echocardiography (TEE) monitoring on a woman with massive pulmonary embolism (PE). Sudden onset of dyspnea happened 7 days after lumbar spine surgery and ventilation/perfusion scan and angiography performed right away were suggestive of PE. Operation was performed 17 days later after invalid anticoagulant treatments and unavailing catheter fragmentation. Intraoperative TEE showed massive emboli in the main and right pulmonary arteries (MPA and RPA) and dilated right atrium (RA) with deviated intraatrial septum. Removal of the emboli was performed smoothly under TEE monitoring. The dilation of RA, right ventricle (RV) and PA were resolved soon after thromboembolectomy. The patient was extubated the next day with obvious improvement of clinical symptoms and discharged two weeks later without neurological sequale. We conclude that TEE can be an excellent tool not only for early diagnosing PE in high risk patients but also for intraoperative monitoring on removing emboli and managing cardiac functions.
Jeng
Chuen-Shin
CS
Department of Anesthesiology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan, R.O.C.
Huang
I-Ren
IR
Lin
Chen-Jung
CJ
Lin
Chih-Peng
CP
Cheng
Ya-Jung
YJ
D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000601:surgery*