Background: Tricuspid valve thrombus with concomitant bilateral pulmonary embolism (PE) and right heart strain poses a significant risk of hemodynamic instability and increased mortality. Case Report: We report the un...Background: Tricuspid valve thrombus with concomitant bilateral pulmonary embolism (PE) and right heart strain poses a significant risk of hemodynamic instability and increased mortality. Case Report: We report the unique case of a female who presented with dyspnea and tachycardia, and was subsequently found to have a structure attached to the tricuspid valve. Concomitantly, she also had bilateral upper extremity deep venous thrombosis (UEDVT) and bilateral sub-massive PE. Thorough clinical assessment, and diagnostic and risk stratification tools were applied to guide the management and disposition. Tricuspid valve thrombus resolved after unfractionated heparin therapy followed by oral anticoagulation as seen on repeat transthoracic echocardiography. We think the readership will benefit from our experience of managing an uncommon and critical clinical presentation of tricuspid valve thrombus in the setting of extensive venous thromboembolism. Conclusion: Careful clinical assessment, risk stratification tools, and close monitoring are needed to guide the management of tricuspid valve thrombus with concomitant bilateral PE and UEDVT.展开更多
Introduction: Portal venous thrombosis and stenosis are uncommon but serious causes of liver transplant graft failure.While surgical thrombectomy can be utilized for the treatment of portal steno-occlusive disease,ven...Introduction: Portal venous thrombosis and stenosis are uncommon but serious causes of liver transplant graft failure.While surgical thrombectomy can be utilized for the treatment of portal steno-occlusive disease,venous interventions with IR have been performed with encouraging results.Case description:69-year-old female with non-alcoholic steatohepatitis cirrhosis who received a liver transplant complicated by portal vein thrombus.Efforts between transplant surgery and IR allowed for successful thrombus removal via direct SMV access.Results:The advantages of direct SMV access with the surgery team include direct approach to accessing thrombus,sparing of liver parenchyma,and significant hemostatic control.展开更多
文摘Background: Tricuspid valve thrombus with concomitant bilateral pulmonary embolism (PE) and right heart strain poses a significant risk of hemodynamic instability and increased mortality. Case Report: We report the unique case of a female who presented with dyspnea and tachycardia, and was subsequently found to have a structure attached to the tricuspid valve. Concomitantly, she also had bilateral upper extremity deep venous thrombosis (UEDVT) and bilateral sub-massive PE. Thorough clinical assessment, and diagnostic and risk stratification tools were applied to guide the management and disposition. Tricuspid valve thrombus resolved after unfractionated heparin therapy followed by oral anticoagulation as seen on repeat transthoracic echocardiography. We think the readership will benefit from our experience of managing an uncommon and critical clinical presentation of tricuspid valve thrombus in the setting of extensive venous thromboembolism. Conclusion: Careful clinical assessment, risk stratification tools, and close monitoring are needed to guide the management of tricuspid valve thrombus with concomitant bilateral PE and UEDVT.
文摘Introduction: Portal venous thrombosis and stenosis are uncommon but serious causes of liver transplant graft failure.While surgical thrombectomy can be utilized for the treatment of portal steno-occlusive disease,venous interventions with IR have been performed with encouraging results.Case description:69-year-old female with non-alcoholic steatohepatitis cirrhosis who received a liver transplant complicated by portal vein thrombus.Efforts between transplant surgery and IR allowed for successful thrombus removal via direct SMV access.Results:The advantages of direct SMV access with the surgery team include direct approach to accessing thrombus,sparing of liver parenchyma,and significant hemostatic control.
