2004 Volume 15 Issue 5 Pages 377-383
Purpose: Pulmonary artery embolectomy was performed in 6 cases between 1994 and 2003 (4 men and 2 women, mean age 62 years, range 28-69 years). These cases were reviewed to evaluate the effectiveness and longterm results of pulmonary artery embolectomy for massive pulmonary embolism (MPE). Methods and Results: MPE occurred perioperatively in 3cases.One patient had a history of superior mesenteric vein thrombosis. All patients had dyspnea, and 2 patients had loss of consciousness. Echocardiography showed right ventricular overload in all cases and emboli in the right atrium in 3 cases. Enhanced chest CT scan showed a definite filling defect in the pulmonary arteries in all cases. Chronic thrombus was also seen in 2 cases. PCPS was used preoperatively in 2 cases. Indications for embolectomy was failure of thrombolytic therapy in one case, shock assisted by PCPS in 2 cases, and right atrial thrombi in 3 cases. Pulmonary artery embolectomy was performed with the aid of extracorporeal circulation. A large amout of embolus was extracted through a transverse arteriotomy in the main pulmonary artery. IVC filters were inserted in all cases. All patients came back from the surgery. One late death occurred one year after the operation. The long term results of the other five cases was excellent (NYHA 1). Conclusions: This operation offers an excellent chance of survival and good long-term results, and is not the last resort reserved for clinically desperate circumstances, but one of several therapeutic options.
