Başkent Üniversitesi Yayınları

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    Massive Pulmonary and Intracardiac Embolism During Liver Transplantation
    (Başkent Üniversitesi, 2010-06) Sheiner, Patricia; Martins, Paulo N.; Kim-Schluger, Leona; Rodriguez-Davalos, Manuel; Martins, Ann-Britt; Krachkova, Nathalia; Facciuto, Marcelo
    Despite prolonged coagulation times and thrombocytopenia associated with end-stage liver disease, formation of thrombi in the circulation seems to occur more frequently during liver transplant than during any other type of major surgery. Here, we report a case of massive pulmonary and intracardiac embolism that resulted in cardiac arrest and intraoperative death. This was diagnosed by transesophageal echocardiography and occurred shortly after induction of anesthesia and initiation of continuous veno-venous hemofiltration without the concomitant use of antifibrinolytic drugs. We discuss the physiologic changes associated with cirrhosis and liver transplant, and review the literature.
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    Successful Pulmonary Thromboendarterectomy for Right Atrial Thrombosis in a Heart Transplant Recipient: A Case Report
    (Başkent Üniversitesi, 2007-06) Bigdeli, A. K.; Beiras-Fernandez, A.; Kaczmarek, I.; Sadoni, S.; Brenner, P.; Schmoeckel, M.; Nikolaou, K.; Reichart, B.
    Acute massive or submassive pulmonary embolism is a life-threatening condition with a poor prognosis. It causes sudden hemodynamic deterioration and warrants immediate surgery. We report the case of a 41-year-old male heart transplant recipient who had not been treated prophylactically for thrombosis, who was referred to our center because of exertional dyspnea after immobilization owing to an injury in one of his legs. Transesophageal echocardiography revealed a large, mobile, right atrial mass originating from a pacemaker lead. Furthermore, contrast-enhanced computed tomography scanning of the chest revealed multiple pulmonary emboli resulting in subtotal occlusion of both pulmonary arteries. Although typically reserved for patients with chronic thromboembolic pulmonary hypertension, surgical thromboendarterectomy was successfully performed. Six months after discharge, the patient is well and has a New York Heart Association class 1 rating. This is the first report of a successful pulmonary thromboendarterectomy in a heart transplant recipient.