Abstrakt
The case report descibes diagnosis and therapy of a patient with deep venous thrombosis and giant thrombembolus localised in the right atrium and pulmonary artery. Etiology of deep venous thrombosis is most probably in a congenital thrombogenic state- mutation in the factor II gene: FII20210A in the heterozygot form was confirmed.
This mutation results in elevated levels of prothrombin due to increase prothrombin synthesis, and is associated with a 3-fold increase in the risk for venous thrombosis. Giant thrombembolus has been seen as a complication in patients with central venous catheter, thrombi from deep venous thrombosis are usually not so large.
The thrombembolectomy from right atrium is rare but life-saving operation in a situation when thrombolysis is contraindicated or high risky. The thrombembolus in our patient had more than 30 cm and others were found in the branches of pulmonary artery.
Despite this, the patient survived and is doing well.