Management of right heart thrombi associated with acute pulmonary embolism: a retrospective, single-center experience

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dc.contributor.authorAkilli, Hakan
dc.contributor.authorGul, Enes Elvin
dc.contributor.authorAribas, Alpay
dc.contributor.authorOzdemir, Kurtulus
dc.contributor.authorKayrak, Mehmet
dc.contributor.authorErdogan, Halil Ibrahim
dc.date.accessioned2024-02-23T14:41:02Z
dc.date.available2024-02-23T14:41:02Z
dc.date.issued2013
dc.departmentNEÜen_US
dc.description.abstractObjective: The mortality of right heart thrombi (RHT) associated with pulmonary embolism (PE) is increased about three to four times. The most devastating scenario is fragmentation of RHT and occurrence of recurrent PE. The reports regarding the management of RHT complicated with PE are very scarce in the current literature. Therefore, we report a single-center experience in this paper. Methods: From January 2006 to December 2011, data of all patients diagnosed with acute PE were analyzed retrospectively. Of the 312 acute PE cases confirmed with computed tomography, total 35 patients who were diagnosed with concomitant RHT (prevalence of 11%) by echocardiography were recruited. After excluding of six patients with metastatic malignancy a total 29 patients were accepted eligible for the analysis. In addition, catheter -induced thrombus (type B) were not included to the study. The difference between categorical variables was analyzed with Chi-square test and continuous variables were analyzed with Mann-Whitney U test. A p value of <0.05 was considered statistically significant. Results: Overall mortality was high (34%) in study population: among undergoing surgery-100%, therapy with thrombolytics -18%, and heparin -27%. Troponin levels were found significantly higher in died patients than that in survived patients (p=0.03). There was no significant difference regarding to clinical and echocardiographic characteristics of patients received heparin versus thrombolytic except for shock index (p=0.02). In addition, patients treated with heparin had increased duration of hospitalization compared to subjects treated with thrombolytic (median: 8 vs 3 days p<0.01). Conclusion: Despite of the low incidence of RHT, a mortal course is still an important problem during PE. The decision on treatment modality should be performed based on the hemodynamic parameters, laboratory findings, and bleeding risk of the patients.en_US
dc.identifier.doi10.5152/akd.2013.173
dc.identifier.endpage533en_US
dc.identifier.issn1302-8723
dc.identifier.issn1308-0032
dc.identifier.issue6en_US
dc.identifier.pmid23835298en_US
dc.identifier.scopus2-s2.0-84884794099en_US
dc.identifier.startpage528en_US
dc.identifier.urihttps://doi.org/10.5152/akd.2013.173
dc.identifier.urihttps://hdl.handle.net/20.500.12452/16672
dc.identifier.volume13en_US
dc.identifier.wosWOS:000326896200012en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherAves Yayinciliken_US
dc.relation.ispartofAnadolu Kardiyoloji Dergisi-The Anatolian Journal Of Cardiologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectRight Heart Thrombusen_US
dc.subjectPulmonary Embolismen_US
dc.subjectThrombolysisen_US
dc.subjectMortalityen_US
dc.titleManagement of right heart thrombi associated with acute pulmonary embolism: a retrospective, single-center experienceen_US
dc.typeArticleen_US

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