Back to Journals » International Medical Case Reports Journal » Volume 2

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

Authors Hudcova J, Kleinman M, Talmor D

Published 29 January 2009 Volume 2009:2 Pages 1—5

DOI https://doi.org/10.2147/IMCRJ.S4922

Review by Single anonymous peer review

Peer reviewer comments 2



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

Creative Commons License © 2009 The Author(s). This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.