Article Text

PDF

Cardiac and pulmonary fat embolectomy for suspected fat embolus
  1. Cyril S. Nelson
  1. Queen Elizabeth Hospital, University of the West Indies, Barbados, West Indies

    Abstract

    Nelson, C. S. (1974).Thorax, 29, 134-137. Cardiac and pulmonary fat embolectomy for suspected fat embolus. There is no specific treatment of fat embolism, whether the embolism is predominantly cerebral, pulmonary, renal or mesenteric.

    A 46-year-old man had fractured his right femur for the third time in December 1971. Seventy hours later he suddenly developed the cardiovascular, respiratory, and cerebral manifestations of post-traumatic fat embolism. His chest radiograph at the onset of symptoms was consistent with fat embolism. He underwent cardiac and pulmonary embolectomy on 7 December 1971 and made a most dramatic recovery. His haemobronchorrhoea, dyspnoea, tachypnoea, hyperpyrexia, and profound shock disappeared at the end of the operation. His only postoperative cerebral disturbance was mild disorientation.

    The pathophysiological changes accompanying fat embolism are due to toxic vasculitis and fat macroglobule aggregations blockading the pulmonary arterioles and capillaries. The blockading concept is the basis for cardiac and pulmonary fat embolectomy. Only a larger series embodying a multicentre trial will show whether or not cardiopulmonary fat embolectomy is a specific treatment of massive fat embolism.

    The purpose of this paper is to report on the technique and result of embolectomy for a suspected fat embolus following fracture of the femur.

    Statistics from Altmetric.com

    Request permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.