Postoperative pulmonary embolism in a three year old with Klippel–Trenaunay syndrome

Case report

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Authors: Jana Hudcova, Monica Kleinman, Daniel Talmor

Published Date January 2009 Volume 2009:2 Pages 1 - 5

DOI: http://dx.doi.org/10.2147/IMCRJ.S4922

Jana Hudcova¹, Monica Kleinman², Daniel Talmor¹

¹Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; ²Department of Anesthesia, Division of Critical Care Medicine, Children’s Hospital Boston and Harvard Medical School, Boston, MA, USA

Abstract: Massive pulmonary embolism (PE) in a small child is a rare event and unified guidelines for its treatment are missing. Timely diagnosis and management of massive pulmonary embolism is of crucial importance for a good outcome. We describe a unique management of PE causing oxygenation failure using a combination of catheter extraction technique, and regional thrombolysis on top of systemic heparin administration and inferior vena cava filter placement. Pulmonary hypertension was treated with inhaled nitric oxide. We believe that catheter extraction technique and regional thrombolysis is an option to consider provided that resources and expertise are available. Preoperative placement of an inferior vena cava filter should be contemplated in such high risk situations.

Keywords: embolectomy, regional thrombolysis, inferior vena cava filter, inhaled nitric oxide

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