Life Life

08/08/2020 - 15:05

Successful emergency cardiovascular intervention for COVID-19 patient

Previously, patient 456 (female, 55 years old, Da Nang) was admitted to Hue Central Hospital Base 2 on July 30, 2020 with the diagnosis of: COVID-19 / rapid progression of ARDS / hypertension, deep vein thrombosis (left), poor prognosis.

Patient with lower limb vein intervention. Photo provided by the Hospital

Since being admitted, the patient has always been in very serious condition. On August 4, through clinical examination and echocardiogram and vascular ultrasound, doctors discovered deep vein thrombosis from the popliteal vein to the left external iliac vein.

Facing that situation, experts from Hanoi Medical University Hospital and Hue Central Hospital have coordinated for urgent consultation and decided to perform inferior vena cava filters placement for emergency and to prevent pulmonary embolism for the patient.

Cardiologists say, DVT can spread to the iliac veins and even higher. A very dangerous complication of deep vein thrombosis is pulmonary embolism, which increases the risk of death, especially in patients with COVID-19 having lung damage and many underlying diseases like patient 456.

Patients with deep vein thrombosis require prolonged oral anticoagulant therapy, but up to 33% of patients with deep vein thrombosis of the lower extremities still suffer secondary pulmonary embolism despite proper treatment. Taking full dose of anticoagulants, in addition, would increase the risk of bleeding, especially in the high-risk group such as COVID-19 patients. Inferior vena cava filters placement help actively prevent pulmonary embolism for patients.

This is not a difficult technique, but this is the first time this procedure was performed on a patient having COVID-19 in severe condition.

Equipment used for this intervention was not available in Hue. To perform this procedure, the Hanoi Medical University Hospital team of experts must urgently mobilize and transfer this device from Hanoi via air transport on August 5. With the coordination and direction of Assoc.Prof.Dr. Nguyen Lan Hieu and Prof. Dr. Pham Nhu Hiep, the patient could have her inferior vena cava filter placement.

After about 45 minutes, the cardiovascular intervention in this special condition was finished successfully. Right in the evening of August 5, the patient had a CT lung scan to check for lung damage and was carefully monitored.

Currently, the patient is still in severe condition, having intensive care at the Center for Isolation and Treatment of COVID-19, Hue Central Hospital Base 2.

By Dong Van