title: Successful pulmonary thromboendarterectomy for right atrial thrombosis in a heart transplant recipient: a case report.
abstract: Acute massive or submassive pulmonary embolism is a life-threatening condition with a poor prognosis. It causes sudden hemodynamic deterioration and warrants immediate surgery. We report the case of a 41-year-old male heart transplant recipient who had not been treated prophylactically for thrombosis, who was referred to our center because of exertional dyspnea after immobilization owing to an injury in one of his legs. Transesophageal echocardiography revealed a large, mobile, right atrial mass originating from a pacemaker lead. Furthermore, contrast-enhanced computed tomography scanning of the chest revealed multiple pulmonary emboli resulting in subtotal occlusion of both pulmonary arteries. Although typically reserved for patients with chronic thromboembolic pulmonary hypertension, surgical thromboendarterectomy was successfully performed. Six months after discharge, the patient is well and has a New York Heart Association class 1 rating. This is the first report of a successful pulmonary thromboendarterectomy in a heart transplant recipient.
authors.affiliation: Department of Cardiac Surgery, Ludwig-Maximilians University, Munich, Germany.
authors.forename: A K
authors.initials: AK
authors.lastname: Bigdeli
authors.forename: A
authors.initials: A
authors.lastname: Beiras-Fernandez
authors.forename: I
authors.initials: I
authors.lastname: Kaczmarek
authors.forename: S
authors.initials: S
authors.lastname: Sadoni
authors.forename: P
authors.initials: P
authors.lastname: Brenner
authors.forename: M
authors.initials: M
authors.lastname: Schmoeckel
authors.forename: K
authors.initials: K
authors.lastname: Nikolaou
authors.forename: B
authors.initials: B
authors.lastname: Reichart
mesh_terms: D000328:Adult; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000175:diagnosis / Q000209:etiology*; D017548:Echocardiography, Transesophageal; D004691:Endarterectomy; D006325:Heart Atria; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D011651:Pulmonary Artery / Q000601:surgery; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D017131:Thrombectomy; D014057:Tomography, X-Ray Computed