Critical role of inferior vena caval filter placement after pulmonary embolectomy.
Surgical pulmonary embolectomy is a definitive treatment for patients with severe pulmonary embolism (PE). Postoperative placement of an inferior vena caval filter (IVCF) may prevent recurrent PE. We present a patient who underwent pulmonary embolectomy in whom postoperative placement of an IVCF was postponed due to hemodynamic instability and severe hemorrhage. Recurrent PE was recognized 12 hours after the initial surgery, and required reoperative pulmonary embolectomy. This report documents that recurrent PE can occur early after pulmonary embolectomy even in the presence of coagulopathy. Therefore, concurrent IVCF placement should be considered during or immediately after pulmonary embolectomy to prevent recurrent pulmonary embolism.
Rosenberger
Peter
P
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospita, Boston, MA, USA.
Shernan
Stanton K
SK
Rawn
James D
JD
Scott
Joseph
J
Eltzschig
Holger K
HK
D017128:Embolectomy / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000175:diagnosis; D011183:Postoperative Complications / Q000517:prevention & control*; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000601:surgery*; D018570:Risk Assessment; D055502:Secondary Prevention; D012720:Severity of Illness Index; D016896:Treatment Outcome; D016306:Vena Cava Filters