Pulmonary embolectomy in the treatment of submassive and massive pulmonary embolism. Academic Article uri icon

Overview

abstract

  • OBJECTIVES: Significant improvements in outcomes after pulmonary embolectomy have resulted in a broadening of indications. We reviewed our experience with pulmonary embolectomy over the past 12 years with an emphasis on preoperative comorbidities and postoperative morbidity and mortality. METHODS: All patients undergoing pulmonary embolectomy over the past 12 years at our institution were analyzed via retrospective chart review. Data on preoperative characteristics, operative procedures and postoperative outcomes were collected. RESULTS: Twenty patients underwent pulmonary embolectomy between 1999 and 2011. The average age was 56 years (range 24-81) and 10 patients (50%) were female. All patients demonstrated right ventricular dysfunction and 19 (95%) demonstrated contraindications to thrombolysis. Twelve patients (60%) demonstrated intermittent hypotension, 4 (20%) required intubation and 3 (15%) demonstrated preoperative or intraoperative cardiac arrest. Survival to discharge was 95%. CONCLUSIONS: Pulmonary embolectomy has been shown to be safe and effective in the treatment of massive pulmonary embolism (PE). We achieved a 95% survival rate in a cohort of patients with significant comorbid status. Pulmonary embolectomy should be considered early in the therapeutic algorithm for patients with submassive PE presenting with right ventricular dysfunction to prevent progression. It can also be performed with good outcomes in those already suffering hemodynamic compromise.

publication date

  • September 10, 2014

Research

keywords

  • Embolectomy
  • Pulmonary Embolism

Identity

Scopus Document Identifier

  • 84908548228

Digital Object Identifier (DOI)

  • 10.1159/000363647

PubMed ID

  • 25227239

Additional Document Info

volume

  • 129

issue

  • 2