Acute Saddle Pulmonary Embolism: Transesophageal Echocardiography Does Not Predict Clot Burden
Published on: 2018-03-28
Acute saddle pulmonary embolism (PE) is associated with significant morbidity and mortality. Transesophageal echocardiography (TEE) can be used to directly visualize the clot within the right, left and main pulmonary artery (PA) and determine secondary signs of obstruction, including right ventricular dysfunction, and leftward bowing of interatrial septum. Despite determining the actual existence of clot, TEE is relatively unreliable and grossly underestimates the actual amount of clot burden in the vessel. We present the case of a 60 year old man with a large saddle pulmonary embolus for whom the use of intraoperative TEE was able to diagnose acute PE but did little to evaluate the amount of thrombus.