Preview

Innovative Medicine of Kuban

Advanced search

Surgical treatment of thromboembolia in the heart right atrium in pregnant women

https://doi.org/10.35401/2500-0268-2021-24-4-50-57

Abstract

Two clinical cases of surgical treatment of cardiac right-chamber thromboembolism in pregnant women are described. Thromboembolism was diagnosed during a routine examination. In the first clinical case, considering the late pregnancy, a thromboembolectomy was performed under artificial circulation after surgical delivery.

In the second case, thrombus removal from the right atrium was performed on a working heart, without interruption of pregnancy. The surgical and postsurgical period proceeded without any specific features and the patients were discharged from the hospital without any complications. These clinical cases show that it is possible to remove thrombus from the right heart chambers without the use of extracorporeal circulation, which is also safe for the mother and the fetus.

About the Authors

I. V. Abdulyanov
Interregional Clinical and Diagnostic Center; Kazan State Medical Academy
Russian Federation

Ildar V. Abdulyanov, Cand. of Sci. (Med.), Associate Professor, Head of Cardiology, X-ray Cardiovascular and Endovascular Surgery Department; Cardiovascular Surgeon of the Cardiac Surgery Unit no. 2

12A, Karbysheva Str., Kazan, 420101



M. R. Gaisin
Interregional Clinical and Diagnostic Center
Russian Federation

Marat R. Gaisin, Cardiovascular Surgeon of the Cardiac Surgery Unit no. 2

Kazan



R. K. Dzhordzhikiya
Interregional Clinical and Diagnostic Center; Kazan State Medical University
Russian Federation

Roin K. Dzhordzhikiya, Head of the Cardiovascular and Endovascular Surgery Department; Cardiovascular Surgeon of the Cardiac Surgery Unit no. 2

Kazan



E. O. Sokolova
Interregional Clinical and Diagnostic Center
Russian Federation

Evgeniya O. Sokolova, Pathologist, Anatomic Pathology Department

Kazan



R. N. Khairullin
Interregional Clinical and Diagnostic Center
Russian Federation

Rustem N. Khairullin, Dr. of Sci. (Med.), the Director General

Kazan



References

1. Fogerty AE. Management of Venous Thromboembolism inPregnancy. Curr Treat Options Cardiovasc Med. 2018;20(8):69. PMID: 30039233. http://doi.org/10.1007/s11936-018-0658-3

2. Meng K, Hu X, Peng X, Zhang Z. Incidence of venous thromboembolism during pregnancy and the puerperium: a systematic review and meta-analysis. J Matern Fetal Neonatal Med. 2015;28(3):245–53. PMID: 24716782. http://doi.org/10.310 9/14767058.2014.913130

3. Hobohm L, Keller K, Valerio L, et al. Fatality rates and use of systemic thrombolysis in pregnant women with pulmonary embolism. ESC Heart Fail. 2020;7(5):2365–2372. PMID: 32567197. PMCID: PMC7524052. http://doi.org/10.1002/ ehf2.12775

4. Medvedev АP, Maksimov АL, Nemirova SV, et al. Experience in Diagnostics and Surgical Treatment of Pulmonary Embolism in Pregnant Women. Sovremennye tehnologii v medicine. 2017;9(4):143–155. (In Russ.) http://dx.doi.org/10.17691/ stm2017.9.4.18

5. Kearon C, Akl EA, Ornelas J, et al. Antithrombotic Therapy for VTE Disease: CHEST Guideline and Expert Panel Report. Chest journal. 2016;149(2):315–352. PMID: 26867832. http://doi.org/10.1016/j.chest.2015.11.026

6. Martillotti G, Boehlen F, Robert-Ebadi H, et al. Treatment options for severe pulmonary embolism during pregnancy and the postpartum period: a systematic review. J Thromb Haemost. 2017;15:1942–50. http://doi.org/10.1111/jth.13802

7. Abdulyanov IV, Vagizov II, Omelyanenko AS. Contemporary approach to treatment of pulmonary artery thromboembolia. Practical medicine. 2015;2(3(88)):35–40. (In Russ.)

8. Medvedev AP, Maximov AL, Zhurko SA, et al. Integrated analysis of surgical methods of pulmonary embolism prevention. Bulletin of modern clinical medicine. 2020;13(3):28–35. (In Russ.) http://doi.org/10.20969/VSKM.2020.13(3).28-35

9. Colombier S, Niclauss L. Successful Surgical Pulmonary Embolectomy for Massive Perinatal Embolism after Emergency Cesarean Section. Ann Vasc Surg. 2015;29(7):1452.e1–4. http:// doi.org/10.1016/j.avsg.2015.04.066

10. Sabzi F, Heidari A. Right Ventricular Thrombosis Combined With Fetal Death and Acrocyanosis in Pregnancy. Acta Med Iran. 2017;55(7):464–469. PMID: 28918617.

11. Gibson NS, Sohne M, Kruip MJ, et al. Further validation and simplification of the Wells clinical decision rule in pulmonary embolism. Thromb Haemost. 2008;99(1):229–34. PMID: 18217159. http://doi.org/10.1160/TH07-05-0321

12. Jiménez D, Aujesky D, Moores L, et al. Simplification of the pulmonary embolism severity index for prognostication in patients with acute symptomatic pulmonary embolism. Arch Intern Med. 2010;170(15):1383–9. PMID: 20696966. http://doi. org/10.1001/archinternmed.2010.199

13. Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures: An Updated Report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration. Anesthesiology. 2017;126:376–393. https://doi. org/10.1097/ALN.0000000000001452


Review

For citations:


Abdulyanov I.V., Gaisin M.R., Dzhordzhikiya R.K., Sokolova E.O., Khairullin R.N. Surgical treatment of thromboembolia in the heart right atrium in pregnant women. Innovative Medicine of Kuban. 2021;(4):50-57. (In Russ.) https://doi.org/10.35401/2500-0268-2021-24-4-50-57

Views: 386


ISSN 2541-9897 (Online)