Review of echocardiographically diagnosed right heart entrapment of pulmonary emboli-in-transit with emphasis on management

Zvi Farfel, Michael Shechter, Zvi Vered, Shmuel Rath, Daniel Goor, Joseph Gafni*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

187 Scopus citations

Abstract

2DE permits detection of thromboemboli transiently entrapped in the right heart chambers while en route to the pulmonary arteries. Review of the 49 cases recorded to date reveals that the supple elongated clot produces a 2DE picture-a mass of changing configuration and striking mobility-that is highly characteristic. Since emboli that become entrapped are large, when managed by medical measures alone they have an attendant mortality rate of 50%, usually soon after 2DE diagnosis, upon completion of pulmonary embolization. Death occurred in 8 of 16 patients treated with anticoagulants, thrombolytic agents, or antiaggregants and in 6 of 13 who received supportive measures only. Of 20 patients referred for surgery (cardiotomy and, in 17, pulmonary embolectomy) only three died, two of them failures of preceding anticoagulant treatment. These data indicate that thromboemboli entrapped in the right heart chambers are best handled as a surgical emergency.

Original languageEnglish
Pages (from-to)171-178
Number of pages8
JournalAmerican Heart Journal
Volume113
Issue number1
DOIs
StatePublished - Jan 1987

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