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Massive pulmonary embolism in the perioperative period almost inevitably leads to death if a delay in diagnosis and treatment occurs. The time window in which treatment should be initiated in order to reduce morbidity and mortality is very short; therefore a so-called golden hour for pulmonary embolism exists. Preoperatively, the role of ultrasound in the diagnosis of this potential life threating condition can be crucial. The present case report describes the role of transesophageal echocardiography after spinal fusion surgery in getting a timely diagnosis and treatment of massive perioperative pulmonary embolism.
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