Pulmonary hypertension could be a risk for deep vein thrombosis in lower extremities after joint replacement surgery

Abstract

SUMMARY A background of Pulmonary Hypertension (PH) indicates a progressive elevation of pulmonary vascular resistance, leading to overfilling, elevation of venous pressure, congestion in various organs, and edema in the venous system. This study aimed to investigate whether PH is a risk factor for deep vein thrombosis (DVT) of the lower extremities after hip and knee replacement surgery. METHODS A total of 238 patients who received joint replacement of lower extremities in our department of orthopedics from January 2009 to January 2012 were examined by echocardiography and Color Doppler flow imaging (CDFI) of the lower extremities. Based on pulmonary artery pressure (PAP), the patients were divided into a normal PAP group (n=214) and PH group (n=24). All the patients were re-examined by CDFI during post-operative care. RESULTS Among the 238 patients, 18 had DVT in the lower extremities after the operation. DVT total incidence rate was 7.56% (18/238). In the PH group, 11 patients had DVT (45.83%, 11/24), but in the normal PAP group, only 7 had DVT (3.27%, 7/214). The incidence of DVT was significantly lower in the normal PAP group than in the PH group (P<0.01). In addition, there was a positive correlation between PAP and the incidence of DVT. CONCLUSION PH could be a high-risk factor for the occurrence of DVT in patient’s lower extremities after joint replacement surgeries.

Aspirin versus low-molecular-weight heparin for thromboprophylaxis after orthopaedic surgery: a systematic review and meta-analysis

“…Due to the damage to the venous blood vessel wall caused by surgical trauma and restrictions of diet and activity, patients who suffered orthopaedic surgery are prone to a hypercoagulable state of blood and eventually DVT events occurred [18,19]. The standardized use of anticoagulants such as aspirin and LMWH can reduce the risk of DVT after surgery, alleviate patients' pain, and have positive significance in promoting patients' recovery process and shortening hospitalization time [20][21][22].…”