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Submitted: 23 January 2017 Modified: 26 January 2017
HERDIN Record #: NCR-PHC-17012311045941

Incidental intra-operative finding of large chronic pulmonary embolism in a patient with mitral stenosis undergoing Mitral Valve Replacement.

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Background. Intraoperative findings may sometimes complicate a previously planned straight forward operation. This paper reports a case of a patient for mitral valve replacement for mitral stenosis with an intraoperative finding of a large chronic pulmonary embolism and the intra-operative decision made to manage this situation.


Case. We report a case of a 30 year old male patient who has rheumatic mitral stenosis for mitral valve replacement. Intraoperatively, the surgeons found a large chronic embolism occupying approximately 80% of the lumen of the main pulmonary artery, and going towards the right and left pulmonary arteries. He underwent pulmonary endarterectomy, Mitral Valve Replacement and Tricuspid Valve Annuloplasty using a modified De Vega technique.


Conclusions. The case presented is one of those rare cases in which a patient with valvular disease specifically mitral stenosis had an intra-operative finding of chronic pulmonary emboli. The decision of performing a more tedious and critical surgery such as valve replacement with pulmonary endarterectomy was a critical intra-operative decision that could have meant either the patient would benefit dramatically and survive longer or be no better off than his pre-operative state.

Publication Type
Journal
Publication Sub Type
Journal Article, Original
Title
Philippine Heart Center Journal
Frequency
Semi-Annual
Publication Date
January-June 2013
Volume
17
Page(s)
50-55
LocationLocation CodeAvailable FormatAvailability
Philippine Heart Center Medical Library Fulltext Print Format