title: Acute pulmonary thromboembolism during mitral valve repair.
abstract: Perioperative pulmonary thromboembolism during cardiac surgery is extremely rare. We report a 55-year-old male, who developed acute pulmonary thromboembolism during mitral valve repair. Intra-operative trans oesophageal echocardiography failed to demonstrate thromboembolus in the pulmonary arteries but it showed the secondary signs of acute pulmonary artery obstruction. Thromboembolectomy was done after high index of suspicion on clinical grounds was found and the patient recovered. The diagnostic accuracy and sensitivity of transoesophageal echocardiography in circumstances with altered haemodynamics is questionable and has not been investigated. Therefore, indirect evidence of pulmonary artery obstruction on echocardiography may have a predictive value and failure to demonstrate pulmonary thromboembolism by this tool should not exclude the possibility of it especially when it is highly suspected.
authors.affiliation: Department of Cardiac Surgery, King Abdulaziz Cardiac Center, National Guard Health Affairs, King Fahad Hospital, Riyadh, Saudi Arabia. nk_jha@hotmail.com
authors.forename: Neerod K
authors.initials: NK
authors.lastname: Jha
authors.forename: Ahmed I
authors.initials: AI
authors.lastname: Rezk
authors.forename: Ahmad S
authors.initials: AS
authors.lastname: Omran
authors.forename: Arif
authors.initials: A
authors.lastname: Hussain
authors.forename: Hani K
authors.initials: HK
authors.lastname: Najm
mesh_terms: D000208:Acute Disease; D002315:Cardiopulmonary Bypass; D017548:Echocardiography, Transesophageal; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D011655:Pulmonary Embolism / Q000175:diagnosis*; D020246:Venous Thrombosis / Q000150:complications