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

Rev Assoc Med Bras (1992). 2019 Aug 5;65(7):946-950. doi: 10.1590/1806-9282.65.7.946.

Abstract

Objective: 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.

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Echocardiography, Doppler
  • Female
  • Hip / blood supply
  • Humans
  • Hypertension, Pulmonary / complications*
  • Hypertension, Pulmonary / diagnostic imaging
  • Knee / blood supply
  • Male
  • Postoperative Complications / etiology
  • Preoperative Period
  • Reference Values
  • Retrospective Studies
  • Risk Factors
  • Venous Thrombosis / diagnostic imaging
  • Venous Thrombosis / etiology*