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Accidental pulmonary emboli noted by TEE during aortic valve replacement: a case report
Chia-Ling Lee1, Jimmy Ong, Bee-Song Chang
1Department of Anesthesiology, Buddhist Tzu-Chi General Hospital and Buddhist Tzu-Chi University, Hualien, 970 Taiwan.
Journal of Clinical Anesthesia
|May 17, 2011
Summary
Diagnosing pulmonary embolism (PE) is challenging. This case highlights how transesophageal echocardiography (TEE) can detect fresh emboli during aortic valve replacement surgery, enabling timely intervention and successful patient recovery.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Diagnostic Imaging
Background:
- Pulmonary embolism (PE) presents diagnostic challenges in clinical practice.
- Aortic valve replacement is a critical cardiac surgical procedure.
Observation:
- Fresh pulmonary emboli were visualized in the right atrium via transesophageal echocardiography (TEE) during elective aortic valve replacement.
- The emboli transiently disappeared from the TEE image, coinciding with acute hemodynamic instability, including tachycardia and elevated pulmonary artery (PA) pressure.
Findings:
- The observed echocardiographic and hemodynamic changes strongly suggested pulmonary embolism.
- Successful pulmonary artery (PA) thromboembolectomy was performed post-cardiopulmonary bypass and aortic valve replacement.
Implications:
- This case underscores the utility of TEE in identifying intraoperative PE during cardiac surgery.
- Prompt diagnosis and surgical intervention for PE can lead to favorable patient outcomes and successful hospital discharge.
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