A Survey of the Current Status of Pulmonary Embolectomy for Massive Pulmonary Embolism

Cross, Frederick S.; A, Mowlem

doi:10.1161/01.cir.35.4s1.i-86

Cited by 53 publications

(23 citation statements)

References 0 publications

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“…Pulmonary embolectomy with cardiopulmonary bypass still carries a significant mortality though this is gradually being reduced. Cross and Mowlem (1967) and Turnier et al (1973) reported operative mortalities of 57% and 29% respectively. Tihe operative mortality at the Bromnton Hospital from 1968 to 1971 was 23% in patients undergoing pulmonary embolectomy as ithe initial treatment (Miller, 1972).…”

Section: Discussionmentioning

confidence: 99%

Comparison by Controlled Clinical Trial of Streptokinase and Heparin in Treatment of Life-threatening Pulmonary Embolism

Tibbutt¹,

Davies²,

Anderson³

et al. 1974

BMJ

241

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SummaryTreatment with heparin or streptokinase was allocated randomly to 30 patients with life-threatening pulmonary embol'sm verified by angiography. Treatment was given for 72 hours and pulmonary angiography was repeated. There was significantly greater (P <0001) evidence of thrombolysis in those patients treated with streptokinase compared with those treated with heparin. The reduction of systolic and mean pulmonary arterial pressures was also significantly greater (P < 0 05 and P < 0-02 respectively) in the streptokinase group.Seven patients failed to complete 72 hours of the trial treatment: five successfully underwent pulmonary embolectomy. Six of these "failures" had initial pulmonary angiographic scores of 24 or more and systemic systolic blood pressure recordings of 100 mm Hg or less. Patients with these features should probably be considered for pulmonary embolectomy as the initial treatment.

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Section: Discussionmentioning

confidence: 99%

Comparison by Controlled Clinical Trial of Streptokinase and Heparin in Treatment of Life-threatening Pulmonary Embolism

Tibbutt¹,

Davies²,

Anderson³

et al. 1974

BMJ

241

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“…The ideal treatment of acute massive embolism is to remove the obstruction as quickly as possible. The mortality of the operation is over 50% (Cross & Mowlem, 1967) and the precise indications for operation are difficult to define. Conservative treatment offers little help in acute massive embolism.…”

Section: Techniquementioning

confidence: 99%

“…Steenberg et al in 1958 reported the first successful embolectomy in America. In the last few years many more successful embolectomies have been performed at many centres (Beall & Cooley, 1965;Makey & Bliss, 1966;Cross & Mowlem, 1967;Barraclough & Braimbridge, 1967;Paneth, 1967;Sautter, 1967). Among the many factors in the recent increase in success, the most important has been the use of cardiopulmonary bypass, first employed successfully in this context by Sharp in 1962.…”

mentioning

confidence: 99%

The surgical treatment of acute massive pulmonary embolism

Gautam

1968

Postgraduate Medical Journal

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“…We have assessed several measures which have revolutionized the man¬ agement of this dying group of pa¬ tients: (1) preoperative circulatory support (PCS) through groin cannulations under local anesthesia, with preliminary closed chest massage (CCM) to preserve brain viability; (2) obligatory pulmonary angiography carried out during circulatory sup¬ port; (3) skillful persistent CCM to fragment and propel proximal embolus into the distal arterial tree, thus allowing resumption of pulmonary blood flow, a distinct improvement in hemodynamics and patient recovery without surgery.…”

mentioning

confidence: 99%