Clinical course of venous thromboembolism following abdominally based microsurgical breast reconstruction: A case series
| Autor: | Rakel M. Zarb, John A. LoGiudice, Aishu Ramamurthi, John B. Hijjawi, Erin L. Doren, Karri A. Adamson |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Computed Tomography Angiography Mammaplasty medicine.medical_treatment Deep vein Rectus Abdominis Breast Neoplasms 030230 surgery Chemoprevention 03 medical and health sciences Postoperative Complications 0302 clinical medicine Risk Factors medicine Humans cardiovascular diseases Venous Thrombosis business.industry Incidence (epidemiology) Anticoagulants Middle Aged Microsurgery medicine.disease Myocutaneous Flap Thrombosis United States Pulmonary embolism Surgery Dyspnea Outcome and Process Assessment Health Care medicine.anatomical_structure 030220 oncology & carcinogenesis Female Risk Adjustment Pulmonary Embolism Complication Breast reconstruction business Body mass index |
| Zdroj: | Journal of Plastic, Reconstructive & Aesthetic Surgery. 74:2550-2556 |
| ISSN: | 1748-6815 |
| Popis: | Summary Background Venous thromboembolism (VTE) is a potentially devastating complication following abdominally based microsurgical breast reconstruction, with a reported incidence of 0.08–4%. The authors aim to describe disease presentation and clinical course following VTE diagnosis in patients within their practice. Methods A retrospective chart review identified patients who underwent microsurgical breast reconstruction from January 2007 through December 2018. Patients with VTE diagnosed within 90 days of surgery were included. Demographics, co-morbidities, signs and symptoms, and characteristics of oncologic, surgical, and post-operative care were analyzed. Results Seven hundred one patients underwent microsurgical breast reconstruction. Eleven patients with pulmonary embolism (PE) and four with deep vein thrombosis (DVT) were identified, resulting in VTE incidence of 2.1% (0.57% DVT, 1.6% PE). Patients were on average 51 years old and had an average body mass index (BMI) of 31.7 kg/m2. Two had a history of VTE, and none had a known hypercoagulable disorder. Using the 2005 Caprini model, all were high risk and seven were highest risk. Among those with PE, the most common symptom was shortness of breath, and the most common signs were desaturation or supplemental oxygen requirements. VTE was diagnosed on average 14.2 days post-operatively (range 2–52 days). Conclusion VTE is an infrequent complication following abdominally based microsurgical breast reconstruction. We recommend a high index of suspicion in women reporting shortness of breath or having desaturation, especially in those with high BMI, high Caprini scores, post-operative complications, or early return to the operating room. |
| Databáze: | OpenAIRE |
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