Abstract 3112: High Incidence of Venous Thrombosis following Cardiac Surgery
Aim: The incidence of venous thrombosis (VT) after general or orthopedic surgical procedures is significantly elevated, generally requiring pharmacologic or mechanical VT prophylaxis. However, there is very limited data available for the incidence and presentation patterns of VT in patients undergoing cardiac surgery.
Method: We collected the data of all patients who underwent cardiac surgery between 1/2004 –12/2006 from the Cleveland Clinic Cardiovascular Information Registry. We then linked with the Non-Invasive Vascular Laboratory database to identify all patients who underwent lower and/or upper extremity venous duplex examination for clinically suspected (symptomatic) VT within one month after the surgical date. Venous thrombosis was defined as “early” when it was documented between 0 –15 days post-op, and “late” if occurred between 16 –30 days.
Results: From the 10,588 cardiac surgeries performed, we identified 1,667 patients with clinically suspected venous thrombosis who underwent duplex evaluation within a single vascular laboratory. Acute, symptomatic VT was diagnosed in 1,272 patients (12.0%). Incidence of symptomatic deep venous thrombosis (DVT), both in upper and lower extremity was observed in 8.2% of patients, and superficial venous thrombosis (SVT) was observed in 3.8%. In symptomatic DVT patients, lower extremity DVT was present in 49.1% patients when compared to 50.8% in the upper extremity. In patients with documented lower extremity DVT, the calf veins were the most common site (71%). Among upper extremity DVT, the internal jugular vein was the most common site (89.6%). The majority of patients with VT (76.1%) presented during the early post-operative period.
Conclusions: In our contemporary cohort of cardiac surgical patients, symptomatic VT was relatively common in both upper and lower extremities, and especially during the early post-operative period. Internal jugular DVT was particularly common. The clinical significance of post-operative VT and optimal management strategies in the setting of cardiac surgery requires further exploration.