title: Upper extremity deep vein thrombosis and pulmonary embolism after coronary bypass surgery: a case report and preliminary results from a prospective study evaluating patients during cardiac rehabilitation.
abstract: A 78-year-old woman with unstable angina underwent coronary bypass surgery with complete cardiac revascularization and no immediate postoperative complications. Six days after surgery, during hospitalization for cardiac rehabilitation, the patient developed severe respiratory distress and pulmonary embolism was diagnosed. Color duplex ultrasound revealed the presence of concomitant upper extremity deep vein thrombosis (UEDVT), ipsilateral to the site of placement of a central venous line, in the absence of lower extremity deep vein thrombosis. We describe this case and provide preliminary data from a prospective observational study evaluating the prevalence of catheter-related UEDVT and symptomatic pulmonary embolism (55 and 1.4% respectively) in a series of 71 consecutive coronary bypass surgery patients admitted to a cardiac rehabilitation facility. Catheter-related UEDVT and pulmonary embolism may complicate coronary bypass surgery and should be taken into consideration when managing patients after surgery.
authors.affiliation: Division of Cardiology, IRCCS S Maugeri Foundation, Tradate (VA), Italy. mambrosetti@fsm.it
authors.forename: Marco
authors.initials: M
authors.lastname: Ambrosetti
authors.forename: Mario
authors.initials: M
authors.lastname: Salerno
authors.forename: Francesco
authors.initials: F
authors.lastname: Dentali
authors.forename: Guido
authors.initials: G
authors.lastname: De Ambroggi
authors.forename: Mara
authors.initials: M
authors.lastname: Zambelli
authors.forename: Roberto F E
authors.initials: RF
authors.lastname: Pedretti
authors.forename: Roberto
authors.initials: R
authors.lastname: Tramarin
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000534:rehabilitation / Q000601:surgery; D000925:Anticoagulants / Q000627:therapeutic use; D001026:Coronary Artery Bypass / Q000009:adverse effects; D004452:Echocardiography; D005260:Female; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D018615:Ultrasonography, Doppler, Color; D034941:Upper Extremity / Q000098:blood supply*; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D014859:Warfarin