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J Card Surg. 2005 May-Jun;20(3):289-90.

Critical role of inferior vena caval filter placement after pulmonary embolectomy.

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  • 1Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospita, Boston, MA, USA.


Surgical pulmonary embolectomy is a definitive treatment for patients with severe pulmonary embolism (PE). Postoperative placement of an inferior vena caval filter (IVCF) may prevent recurrent PE. We present a patient who underwent pulmonary embolectomy in whom postoperative placement of an IVCF was postponed due to hemodynamic instability and severe hemorrhage. Recurrent PE was recognized 12 hours after the initial surgery, and required reoperative pulmonary embolectomy. This report documents that recurrent PE can occur early after pulmonary embolectomy even in the presence of coagulopathy. Therefore, concurrent IVCF placement should be considered during or immediately after pulmonary embolectomy to prevent recurrent pulmonary embolism.

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