Cardiovascular collapse during elective orthopedic surgery: massive intraoperative pulmonary thromboembolism treated with emergent cardiopulmonary bypass

Intraoperative pulmonary embolism and intracardiac thrombosis complicating liver transplantation: a systematic review

“…Formation of thrombi in the central venous and pulmonary circulation seems to occur more frequently during OLT than during any other type of major surgery. Intraoperative pulmonary embolism (PE) or intracardiac thrombosis (ICT) have been reported only sporadically in non-oncological patients undergoing other types of major surgery, such as orthopedic and cardiovascular surgery [10][11][12]. Although the estimated incidence of PE or ICT in liver transplant recipients is low (around 1-1.5%) [13,14], these complications are potentially fatal, and therefore of great clinical relevance.…”

Intraoperative pulmonary embolism and intracardiac thrombosis complicating liver transplantation: a systematic review

“…Formation of thrombi in the central venous and pulmonary circulation seems to occur more frequently during OLT than during any other type of major surgery. Intraoperative pulmonary embolism (PE) or intracardiac thrombosis (ICT) have been reported only sporadically in non‐oncological patients undergoing other types of major surgery, such as orthopedic and cardiovascular surgery [10–12]. Although the estimated incidence of PE or ICT in liver transplant recipients is low (around 1–1.5%) [13,14], these complications are potentially fatal, and therefore of great clinical relevance.…”

Venous thromboembolism

“…Interestingly, 6% of patients with a DVT and 12% of patients with a PE will suffer cardiac arrest within 1 month of diagnosis. 23 Given their infrequency along with the lack of broad consensus for initial treatment, resuscitative efforts remain largely symptomatic until the actual fibrinolysis can take place. Nurses should have increased vigilance when patients present with the following: decreased systolic BP, right ventricular dysfunction, chronic obstructive pulmonary disease, age greater than 70 years, heart failure, cancer, and unexpected tachycardia.…”

“…22 Several comorbidities have been associated with an increased mortality when PE is present. 23 As pulmonary blood flow becomes dampened due to mechanical obstruction by the embolus, pulmonary vasoconstriction from hypoxia further impedes the flow of blood to the left side of the heart. 22 Although DVT and PE are not uncommon among the hospitalized patients, massive acute pulmonary emboli are infrequent.…”