Deep vein thrombosis and pulmonary embolism in coronary artery bypass graft: postoperative diagnostic evaluation independently of clinical suspicion

• Grant number: 10/15530-7
• Support Opportunities: Regular Research Grants
• Start date: March 01, 2011
• End date: August 31, 2013
• Field of knowledge: Health Sciences - Medicine
• Principal Investigator: Caio de Brito Vianna
• Grantee: Caio de Brito Vianna
• Host Institution: Instituto do Coração Professor Euryclides de Jesus Zerbini (INCOR). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil

Abstract

Deep vein thrombosis (DVT) and pulmonary embolism (PE) are frequent complications in hospitalized patients, particularly in post-operative, determine increased hospital stay and costs and can be potentially fatal. After coronary artery bypass grafting (CABG), DVT and PE may be masked and thus under-diagnosed due to clinical and radiological behavior of this surgery, from the handling of lower limbs and chest, release of inflammatory mediators, mechanical ventilation and drugs, among others.Most believe that all patients should receive prophylactic measures for DVT e PE. However, many centers as well as ours, do not use routine prophylaxis after CABG, such as low molecular weight heparin, like is commonly applied in other high risk surgical procedures, for fear of bleeding and lack of randomized data (Guideline of the American College of Chest Physicians recommends the use of prophylactic heparin in these patients only with evidence level "C"). This stems from the limited quality and limited number of studies that evaluated the actual incidence or prevalence of DVT or PE, as well as the absence of clinical trials that have tested the effectiveness of heparin in preventing these disorders after CABG. We intend to carefully research the diagnosis of DVT and / or PE in 100 patients after CABG and so we come to know the actual prevalence, correlation between the two complications, associated factors and clinical relevance of them, giving patients diagnosed the benefit of treatment and allow after completion of studies to test appropriate methods of prophylaxis, if it concludes that there is relevance. (AU)

Scientific publications

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

VIANA, VITOR B.; MELO, EMANOEL R.; TERRA-FILHO, MARIO; DALLAN, LUIS A.; GONZALEZ, MARIA M.; HAJJAR, LUDHMILA A.; JATENE, FABIO B.; CESAR, LUIZ A.; VIANNA, CAIO B.. Frequency of Deep Vein Thrombosis and/or Pulmonary Embolism After Coronary Artery Bypass Grafting Investigation Regardless of Clinical Suspicion. AMERICAN JOURNAL OF CARDIOLOGY, v. 119, n. 2, p. 237-242, JAN 15 2017. (10/15530-7)