2024-04-09 18:53:54
When Vilma was at home, she couldn’t even stand on her feet, her son called an ambulance. “The doctors in Jurbarka suspected a pulmonary embolism, I was rushed to Kaunas clinics,” says the woman.
In the Kaunas Clinics Emergency Department, Vilma underwent a chest computed tomography examination, which showed multiple filling defects of the contrast material, characteristic of acute pulmonary embolism, and signs of right heart overload.
In the performed blood tests, an increased concentration of troponin was observed, the patient was suffering from shortness of breath, the blood oxygen saturation was low, and the heart rate was high, although the rhythm was not disturbed. Vilma was diagnosed with medium-high risk pulmonary embolism.
The Pulmonology Clinic of Kaunas Clinics treats over 300 cases of pulmonary embolism per year. The causes of pulmonary embolism are diverse, and risk factors are divided into temporary or transitory and permanent, for example, heart rhythm disorders, surgical operations, trauma with fractures, oncological diseases, inflammatory or autoimmune diseases, genetic causes, thrombophilia, but some patients sometimes do not have any risk factor .
“Acute pulmonary embolism has a mortality rate of 7-11%. people, most of them have not yet started treatment (up to 90 percent of all cases), so speed is extremely important, says Assoc. Dr. Deimantė Hoppenot, pulmonologist at Kaunas Clinics Pulmonology Clinic. – According to literature data, even about 10 percent. patients with acute pulmonary embolism die within the first hour.”
With the possibility of applying catheter-based pulmonary embolism treatment methods in Kaunas clinics, the Pulmonary Embolism Response Team was created in order to diagnose and optimize the treatment of pulmonary embolism as best as possible. When a pulmonary embolism of medium and high risk is detected in a patient, the specific situation is discussed in a general council.
“At the time, it was decided that patient Vilma’s condition is serious, but stable, the risk of pulmonary embolism is moderately higher, so the best possible treatment for this patient is to suck out the thrombi in the lungs,” says doc. Dr. D. Hoppenot. “After it is decided to suck out thrombi from the pulmonary arteries, the patient is transferred to the hands of experienced interventional cardiologists.”
Dr. Rasa Ordienė, cardiologist at the Interventional Cardiology Department of the Kaunas Clinics Cardiology Clinic, who together with the team performed the thrombus aspiration on Vilma, says that such a procedure was performed for the first time in Kaunas clinics in November, and that a new generation catheter of this type was used for the first time both in Lithuania and the Baltic States. .
Under local anesthesia, in a one-centimeter incision, the heart is reached with the mentioned catheter through the inguinal vein, the heart is passed through it to the lungs, after localizing the thrombi, they are suctioned.
“The effectiveness of the treatment is immediately visible: oxygen absorption improves, arterial blood pressure stabilizes, shortness of breath decreases, and the risk of death also immediately decreases. Meanwhile, if only medical treatment is prescribed, the risk of death decreases slowly, and the clinical effect is also felt later, after a few days”, explains Dr. R. Ordienė.
As in all minimally invasive cardiology operations, an interventional cardiologist, an assisting nurse and a laboratory technician participate in the procedure. “This procedure does not require full anesthesia, only local anesthesia is used,” says the cardiologist.
The procedure went smoothly, the patient felt well, her shortness of breath decreased after the procedure, her general well-being improved, and she could be immediately transferred to the Intensive Care Unit for further monitoring.
“I felt an improvement immediately after the procedure, it seems that even my eyes have become brighter,” recalls Vilma.
After the procedure, the patient is referred for regular care by a pulmonologist. “For the majority of patients, the thrombi in the pulmonary arteries dissolve and the symptoms disappear after a while, in some patients, the symptoms that occurred during the embolism remain – 0.1-9.1 percent. In some cases, undissolved thrombi cause chronic thromboembolic pulmonary hypertension and tire the right heart, says Assoc. Dr. D. Hoppenot. – In some patients who suffer from dyspnea after pulmonary embolism, the right heart is not affected and undissolved thrombi lead to chronic thromboembolic pulmonary disease. These diagnoses are determined after performing various tests at the Pulmonary Hypertension Center of Kaunas Clinics.”
“The thrombus suction procedure performed is very innovative, not yet performed in all European countries. We are happy to help the patients of Kaunas clinics using the most modern technologies. Currently, we have performed three such procedures, all of which were successful,” says Dr. R. Ordienė.
2024-04-09 18:53:54