Embolectomy for acute pulmonary thromboembolism: From Trendelenburg’s procedure to the contemporary surgical approach

Fukuda, Ikuo; Taniguchi, Satoshi

doi:10.1007/s00595-010-4416-8

Cited by 13 publications

(13 citation statements)

References 37 publications

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“…When acute pulmonary thromboembolism is accompanied by chronic pulmonary embolism (acute on chronic thromboembolism), pulmonary endarterectomy should be considered in addition to pulmonary embolectomy. Fukuda and Taniguchi [ 8 ] stated that pulmonary embolectomy for acute on chronic thromboembolism is contraindicated because of the risk for persistent pulmonary hypertension, right heart failure, and intractable pulmonary hemorrhage. However, in our patient, we not only performed pulmonary embolectomy, but also identified a chronic organized thrombus and performed a pulmonary endarterectomy with a successful recovery.…”

Section: Discussionmentioning

confidence: 99%

Life-Threatening Acute on Chronic Pulmonary Thromboembolism Requiring Extracorporeal Membrane Oxygenation

Lee

Kim

et al. 2018

Korean J Thorac Cardiovasc Surg

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A 71-year-old female patient was admitted to the emergency department with sudden aggravation of chest pain and severe dyspnea. Computed tomography showed extensive pulmonary thromboembolism. Venoarterial extracorporeal membrane oxygenation (ECMO) was instituted due to sudden bradycardia and hypotension. An emergency operation was performed. However, chronic pulmonary thromboembolism combined with an acute pulmonary embolism was detected in the operating room. Embolectomy and endarterectomy were performed. ECMO was then discontinued. The patient was discharged on postoperative day 13 with warfarin for anticoagulation. The patient was followed up for 46 months as an outpatient without further thromboembolic events.

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Section: Discussionmentioning

confidence: 99%

Life-Threatening Acute on Chronic Pulmonary Thromboembolism Requiring Extracorporeal Membrane Oxygenation

Lee

Kim

et al. 2018

Korean J Thorac Cardiovasc Surg

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“…This pathological condition is similar to acute pulmonary thromboembolism. When embolectomy for acute pulmonary thromboembolism is performed, hypothermic circulatory arrest or cardiac arrest is not mandatory [ 9 ]. In our case, the findings of preoperative chest CT and echocardiography suggested the occurrence of acute pulmonary embolism [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Right atrial myxoma with a large tumor embolus in the left pulmonary artery

Ikeda

Tsukada

Konishi

et al. 2014

Journal of Surgical Case Reports

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Cardiac myxoma, the most common primary cardiac tumor, usually develops in the left atrium. Right atrial myxomas are rare, especially those accompanied by pulmonary tumor embolism. We describe a case of a right atrial myxoma with a large tumor embolus in the left pulmonary artery. A 74-year-old man was referred to our hospital for the treatment of a right atrial tumor. Upon echocardiography, the right atrial tumor was revealed to have a mobile and tail-like surface projection. In addition, computed tomography showed that an embolus was wedged into the left pulmonary artery. We performed an emergency surgery to remove both the right atrial tumor and the pulmonary embolus. Histopathological examination revealed them both to be myxoma. Right atrial myxoma with a large pulmonary tumor embolus is a serious condition and emergency surgery to remove both cardiac tumors and pulmonary emboli should be performed to avoid the risk of sudden death.

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“…Surgical approach is another treatment option and is defined as exploration of the right chambers and the pulmonary arteries under cardiopulmonary bypass (14). Many investigators suggest that surgery is the most efficient treatment.…”

Section: Discussionmentioning

confidence: 99%

Management of right heart thrombi associated with acute pulmonary embolism: a retrospective, single-center experience

Akıllı

Gül²,

Arıbaş³

et al. 2013

Anadolu Kardiyol Derg

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Objective: The mortality of right heart thrombi (RHT) associated with pulmonary embolism (PE) is increased about three to four times. The most devastating scenario is fragmentation of RHT and occurrence of recurrent PE. The reports regarding the management of RHT complicated with PE are very scarce in the current literature. Therefore, we report a single-center experience in this paper. Methods: From January 2006 to December 2011, data of all patients diagnosed with acute PE were analyzed retrospectively. Of the 312 acute PE cases confirmed with computed tomography, total 35 patients who were diagnosed with concomitant RHT (prevalence of 11%) by echocardiography were recruited. After excluding of six patients with metastatic malignancy a total 29 patients were accepted eligible for the analysis. In addition, catheter -induced thrombus (type B) were not included to the study. The difference between categorical variables was analyzed with Chi-square test and continuous variables were analyzed with Mann-Whitney U test. A p value of <0.05 was considered statistically significant. Results: Overall mortality was high (34%) in study population: among undergoing surgery-100%, therapy with thrombolytics -18%, and heparin -27%. Troponin levels were found significantly higher in died patients than that in survived patients (p=0.03). There was no significant difference regarding to clinical and echocardiographic characteristics of patients received heparin versus thrombolytic except for shock index (p=0.02). In addition, patients treated with heparin had increased duration of hospitalization compared to subjects treated with thrombolytic (median: 8 vs 3 days p<0.01). Conclusion: Despite of the low incidence of RHT, a mortal course is still an important problem during PE. The decision on treatment modality should be performed based on the hemodynamic parameters, laboratory findings, and bleeding risk of the patients. (Anadolu Kardiyol Derg 2013; 13: 528-33) Key words: Right heart thrombus, pulmonary embolism, thrombolysis, mortality Original Investigation Özgün Araşt›rma 528ÖZET Amaç: Pulmoner emboli (PE) ile ilişkili sağ kalp trombüslerinin mortalitesi 3-4 kat artmaktadır. En korkulan senaryo ise sağ kalp trombüslerinin parçalanması sonucunda rekürren pulmoner emboli gelişmesidir. Pulmoner embolilere eşlik eden sağ kalp trombüsü vakalarının tedavisi zordur ve bu konu ile ilgili literatürde yeterli veri bulunmamaktadır. Yöntemler: Ocak 2006 ila Aralık 2011 tarihleri arasında akut pulmoner emboli tanısı almış 312 hastanın verileri retrospektif olarak incelendi. Bilgisayarlı tomografi ile tanı almış 312 akut PE hastalarından ekokardiyografide sağ kalp trombüsü bulunan 35 hasta çalışmaya alındı. Metastatik malignansi bulunan 6 hasta çalışmadan dışlandı. Yirmi dokuz hasta değerlendirilme için uygun bulundu. Hastaların ekokardiyografik raporları da incelendi. Ayrıca katetere bağlı gelişen trombüs (tip B) vakaları da çalışmaya dahil edilmedi. Kategorik değişkenlerin karşılaştırılmasında Ki-kare ve non-parametrik sürekli de...

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Embolectomy for acute pulmonary thromboembolism: From Trendelenburg’s procedure to the contemporary surgical approach

Cited by 13 publications

References 37 publications

Life-Threatening Acute on Chronic Pulmonary Thromboembolism Requiring Extracorporeal Membrane Oxygenation

Life-Threatening Acute on Chronic Pulmonary Thromboembolism Requiring Extracorporeal Membrane Oxygenation

Right atrial myxoma with a large tumor embolus in the left pulmonary artery

Management of right heart thrombi associated with acute pulmonary embolism: a retrospective, single-center experience

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