Acute pulmonary thromboembolism during the surgery for bilateral lower extremity fracture

A 50-year-old woman underwent open reduction and internal fixation for bilateral lower extremity fracture under general anesthesia. During the surgery, arterial oxygen saturation and expired CO2 concentration dropped suddenly when the left limb was fixed. Immediately, we performed aspiration of the pulmonary thrombus and inserted a temporary infra-vena cava filter followed by heparinization. Ten days later, we carried out the surgery on the right limb uneventfully. The major cause of APTE is deep vein thrombosis (DVT), which is extremely common during perioperative period. Therefore, we must perform antithrombotic therapy for the patient at high risk for DVT.