Faculty Collaboration Database

Clinical course of venous thromboembolism following abdominally based microsurgical breast reconstruction: A case series. J Plast Reconstr Aesthet Surg 2021 Oct;74(10):2550-2556

Date

04/27/2021

Pubmed ID

33896741

DOI

10.1016/j.bjps.2021.03.020

Scopus ID

2-s2.0-85106231476 (requires institutional sign-in at Scopus site)   4 Citations

Abstract

BACKGROUND: Venous thromboembolism (VTE) is a potentially devastating complication following abdominally based microsurgical breast reconstruction, with a reported incidence of 0.08-4%. The authors aim to describe disease presentation and clinical course following VTE diagnosis in patients within their practice.

METHODS: A retrospective chart review identified patients who underwent microsurgical breast reconstruction from January 2007 through December 2018. Patients with VTE diagnosed within 90 days of surgery were included. Demographics, co-morbidities, signs and symptoms, and characteristics of oncologic, surgical, and post-operative care were analyzed.

RESULTS: Seven hundred one patients underwent microsurgical breast reconstruction. Eleven patients with pulmonary embolism (PE) and four with deep vein thrombosis (DVT) were identified, resulting in VTE incidence of 2.1% (0.57% DVT, 1.6% PE). Patients were on average 51 years old and had an average body mass index (BMI) of 31.7 kg/m2. Two had a history of VTE, and none had a known hypercoagulable disorder. Using the 2005 Caprini model, all were high risk and seven were highest risk. Among those with PE, the most common symptom was shortness of breath, and the most common signs were desaturation or supplemental oxygen requirements. VTE was diagnosed on average 14.2 days post-operatively (range 2-52 days).

CONCLUSION: VTE is an infrequent complication following abdominally based microsurgical breast reconstruction. We recommend a high index of suspicion in women reporting shortness of breath or having desaturation, especially in those with high BMI, high Caprini scores, post-operative complications, or early return to the operating room.

Author List

Zarb RM, Ramamurthi A, Doren EL, LoGiudice JA, Hijjawi JB, Adamson KA

Authors

Erin L. Doren MD Associate Professor in the Plastic Surgery department at Medical College of Wisconsin
John A. LoGiudice MD Professor in the Plastic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Anticoagulants
Breast Neoplasms
Chemoprevention
Computed Tomography Angiography
Dyspnea
Female
Humans
Mammaplasty
Middle Aged
Myocutaneous Flap
Postoperative Complications
Pulmonary Embolism
Rectus Abdominis
Risk Adjustment
Risk Factors
United States
Venous Thrombosis