Pulmonary embolectomy for acute massive pulmonary embolism: an analysis of 71 cases

• Published in: British Heart Journal 1988-09, Vol.60 (3), p.196-200
• Main Authors: Gray, H H, Morgan, J M, Paneth, M, Miller, G A
• Format: Article
• Language: English
• Subjects: Acute Disease; Adolescent; Adult; Aged; Anticoagulants - administration & dosage; Biological and medical sciences; Cardiology. Vascular system; Chronic cor pulmonale; Drug Administration Schedule; Female; Heart; Heart Arrest - etiology; Humans; London; Male; Medical sciences; Middle Aged; Pneumology; Postoperative Complications; Pulmonary Artery - surgery; Pulmonary Embolism - complications; Pulmonary Embolism - mortality; Pulmonary Embolism - surgery; Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases
• ISSN: 0007-0769; 1355-6037; 1468-201X; 2053-5864
• DOI: 10.1136/hrt.60.3.196

Between 1964 and 1986 a total of 71 pulmonary embolectomies were performed for acute massive pulmonary embolism. All patients were severely compromised haemodynamically. Sixteen (64%) of 25 patients who had sustained significant periods of cardiac arrest before operation died. The principal cause of death in this group was severe neurological damage. Five (11%) of the 46 who had not had a cardiac arrest died. The 50 (70%) patients who survived did so largely without morbidity during their hospital admission and in the follow up period. Most were not treated with long term anticoagulants and only two had another embolism. When a patient with acute massive pulmonary embolism is too ill to be given thrombolytic treatment, or when thrombolysis is either contraindicated or too slow in producing benefit, pulmonary embolectomy remains an effective alternative treatment with an acceptable mortality.