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Investigation of the embolic foci through echocardiographic evaluation in patients undergoing urgent femoral embolectomy [Anatol J Cardiol]
Anatol J Cardiol. 2009; 9(1): 37-40

Investigation of the embolic foci through echocardiographic evaluation in patients undergoing urgent femoral embolectomy

Ufuk Yetkin1, Burçin Abud2, Orhan Gökalp3, Berkan Özpak4, Aykut Şahin5, Tayfun Göktoğan5, Ali Gürbüz6
1Department of Cardiovascular Surgery İzmir Atatürk Training and Research Hospital, İzmir, Turkey
2Department of Cardiovascular Surgery, Atatürk Education and Research Hospital, Yeşilyurt, İzmir
3İzmir Atatürk Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi Kliniği, İzmir, Türkiye
4Clinic of Cardiovascular Surgery, İzmir Atatürk Education and Training Hospital, İzmir Turkey
5Department of Cardiovascular Surgery, İzmir Atatürk Training and Research Hospital, İzmir, Turkey
6Atatürk Eğitim ve Araştırma Hastanesi, Kalp Damar Cerrahisi Kliniği, İzmir-Türkiye

Objective: The determination of the source of embolism in patients with lower extremity arterial emboli is a major clinical problem. A review of the literature focusing on large patient series showed that the heart is the embolic source in 78% of these patients. The aim of this study was to determine the role of early postoperative echocardiographic investigations in the determination of embolic origin. Methods: This retrospective study group consisted of 57 patients in whom we performed 63 unilateral and bilateral urgent femoral embolectomies. Bilateral urgent femoral embolectomy was performed in 6 of the 57 patients included in the study and unilateral intervention was performed in the rest. Besides the features regarding age and sex, the cardiac rhythms of the patients during their application to our clinic were evaluated. In order to determine the origin of the acute peripheral arterial occlusion, transthoracic echocardiography was performed in all patients in the first 24 hours after the embolectomy. Results: In 6 patients who underwent bilateral femoral embolectomy, distinct heart valve pathologies were determined. As for the 51 patients who underwent urgent unilateral femoral embolectomy, it was determined that 28 (55%) had serious cardiac pathologies. Among these 28 patients, 14 (50%) underwent the required open-heart surgery interventions after the completion of further examinations. It was determined that, in our series, 14 (64%) of the 22 patients with serious mitral valve pathologies had a history of acute joint rheumatism. Conclusion: Regardless of whether the interventions are bilateral or unilateral, we believe that echocardiographic investigation should be performed in all patients during the early postoperative period in order to prevent recurrence by the determination of the thromboemboli source. Thus, accompanying serious intracardiac pathologies can be treated and the development of additional peripheral emboli can be prevented.

Keywords: Peripheral arterial embolism, femoral embolectomy, echocardiography, mitral stenosis


Ufuk Yetkin, Burçin Abud, Orhan Gökalp, Berkan Özpak, Aykut Şahin, Tayfun Göktoğan, Ali Gürbüz. Investigation of the embolic foci through echocardiographic evaluation in patients undergoing urgent femoral embolectomy. Anatol J Cardiol. 2009; 9(1): 37-40


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