[Fulminant pulmonary artery embolism in the early postoperative phase. Use of transesophageal echocardiography in acute diagnostics].
Acute pulmonary embolism is a serious perioperative complication with a high mortality. A case of early onset pulmonary embolism with acute right heart failure and resuscitation after spinal surgery is reported. The diagnosis was rapidly and reliably confirmed by transesophageal echocardiography (TEE) and a right atrial thrombus was detected. Persistent life-threatening hemodynamic instability required thrombolysis with 100 mg recombinant tissue-type plasminogen activator (rt-PA). The patient survived this critical situation but sustained permanent paraparesis.
Hohn
A
A
Klinik für Anästhesiologie und Operative Intensivmedizin, Krankenhaus Merheim, Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke, Ostmerheimerstrasse 200, 51109 Köln. hohna@kliniken-koeln.de
Trojan
S
S
Poels
M
M
Sakka
S G
SG
Wappler
F
F
D000208:Acute Disease; D000368:Aged; D001784:Blood Gas Analysis; D017548:Echocardiography, Transesophageal; D006333:Heart Failure / Q000150:complications; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D020335:Paraparesis / Q000209:etiology; D011183:Postoperative Complications / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000628:therapy; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000628:therapy; D012151:Resuscitation; D013130:Spinal Stenosis / Q000601:surgery; D013131:Spine / Q000601:surgery; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use
D010959:Tissue Plasminogen Activator