Pulmonary embolism after cardiac surgery

Department of Surgery, Brockton/West Roxbury Department of Veterans Affairs Medical Center, Boston, Massachusetts.

OBJECTIVES. We examined the incidence of pulmonary embolism after cardiac surgery. BACKGROUND. Because venous thromboembolism is considered to be an uncommon complication after cardiac surgery, its incidence was documented in a consecutive series of 1,033 patients who underwent cardiac surgery over a 5-year period. METHODS. Parallel cohorts of patients in a tertiary referral center were evaluated and the incidence of pulmonary embolism was compared in subgroups of patients undergoing coronary bypass surgery, valve surgery and combined procedures. RESULTS. Pulmonary embolism developed in 33 (3.2%) of the 1,033 cardiac surgical patients, within 2 weeks of a coronary bypass operation in most; it did not develop in any patient who had isolated valve replacement surgery (p < 0.05). The diagnosis of pulmonary embolism was established by pulmonary angiography in 24 patients, ventilation/perfusion lung scan in 3, postmortem examination in 5 and clinical examination in 1 patient. Important risk factors for pulmonary embolism included prolonged postoperative recovery, obesity and hyperlipidemia. The mortality rate was 18.7% in patients with in contrast to 3.3% in those without pulmonary embolism (p < 0.01). CONCLUSIONS. Although pulmonary embolism is rare after isolated valve replacement, it is not an uncommon complication after coronary bypass surgery.

This article has been cited by other articles:

				J. Dunning, M. Versteegh, A. Fabbri, A. Pavie, P. Kolh, U. Lockowandt, S. A.M. Nashef, and on behalf of the EACTS Audit and Guidelines Commit Guideline on antiplatelet and anticoagulation management in cardiac surgery. Eur. J. Cardiothorac. Surg., July 1, 2008; 34(1): 73 - 92. [Abstract] [Full Text] [PDF]

				W. H. Geerts, D. Bergqvist, G. F. Pineo, J. A. Heit, C. M. Samama, M. R. Lassen, and C. W. Colwell Prevention of Venous Thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition) Chest, June 1, 2008; 133(6_suppl): 381S - 453S. [Abstract] [Full Text] [PDF]

				Z. I. Khalpey, R. B. Ganim, and J. D. Rawn Postoperative Care of Cardiac Surgery Patients Card. Surg. Adult, January 1, 2008; 3(2008): 465 - 486. [Full Text]

				M. M. Madani and S. W. Jamieson Pulmonary Embolism and Pulmonary Thromboendarterectomy Card. Surg. Adult, January 1, 2008; 3(2008): 1309 - 1332. [Full Text]

				V. Close, M. Purohit, M. Tanos, and S. Hunter Should patients post-cardiac surgery be given low molecular weight heparin for deep vein thrombosis prophylaxis? Interactive CardioVascular and Thoracic Surgery, October 1, 2006; 5(5): 624 - 629. [Abstract] [Full Text] [PDF]

				A. Vincentelli, B. Jude, and S. Belisle Antithrombotic therapy in cardiac surgery: [Traitement antithrombotique en chirurgie cardiaque]. Can J Anesth, June 1, 2006; 53(6_suppl): S89 - S102. [Abstract] [Full Text] [PDF]

				R. Wynne and M. Botti Postoperative Pulmonary Dysfunction in Adults After Cardiac Surgery With Cardiopulmonary Bypass: Clinical Significance and Implications for Practice Am. J. Crit. Care., September 1, 2004; 13(5): 384 - 393. [Abstract] [Full Text] [PDF]

				C. Weissman Pulmonary Complications After Cardiac Surgery Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 2004; 8(3): 185 - 211. [Abstract] [PDF]

				M. Ambrosetti, M. Salerno, M. Zambelli, F. Mastropasqua, R. Tramarin, and R. F. E. Pedretti Deep Vein Thrombosis Among Patients Entering Cardiac Rehabilitation After Coronary Artery Bypass Surgery Chest, January 1, 2004; 125(1): 191 - 196. [Abstract] [Full Text] [PDF]

				F. A. Anderson Jr. and F. A. Spencer Risk Factors for Venous Thromboembolism Circulation, June 17, 2003; 107(90231): I-9 - 16. [Abstract] [Full Text] [PDF]

				M. M. Madani and S. W. Jamieson Pulmonary Thromboendarterectomy Card. Surg. Adult, January 1, 2003; 2(2003): 1205 - 1228. [Full Text]

				Guidelines on diagnosis and management of acute pulmonary embolism Eur. Heart J., August 2, 2000; 21(16): 1301 - 1336. [PDF]

				W. I. Awad, A. Coumbe, and R. K. Walesby Venous gangrene of the lower limbs following aortic valve replacement for native valve endocarditis Eur. J. Cardiothorac. Surg., October 1, 1999; 14(4): 440 - 442. [Abstract] [Full Text] [PDF]

				P.-O. Hansson, H. Eriksson, L. Welin, K. Svardsudd, and L. Wilhelmsen Smoking and Abdominal Obesity: Risk Factors for Venous Thromboembolism Among Middle-aged Men: "The Study of Men Born in 1913" Arch Intern Med, September 13, 1999; 159(16): 1886 - 1890. [Abstract] [Full Text] [PDF]