Pulmonary embolectomy: A 20-year experience at one center

Meyer, Guy; Tamisier, Daniel; Sors, H.; Stern, M.; Vouhé, Pascal; Makowski, Serge; Neveux, Jean-Yves; Leca, F; Even, P

doi:10.1016/0003-4975(91)90792-o

Cited by 187 publications

(79 citation statements)

References 11 publications

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“…The in-hospital mortality rate of this patient cohort was 28.6%, which accords with the high mortality rate (18-33%) reported by other investigators, [12][13][14] but is considerably higher than the 8% and 9.5% respective mortality rates of the hemodynamically stable patients included in the Urokinase in Pulmonary Embolism Trial 15 and the Prospective Investigation of Pulmonary Embolism Diagnosis trial. 16 Anticoagulation with heparin was initiated in all 35 patients in the present study and thomboembolytic agents were given to 30 (85.7%).…”

Section: Discussionsupporting

confidence: 89%

Treatment of Acute Massive/Submassive Pulmonary Embolism.

Tayama

Ouchida

Teshima

et al. 2002

Circ J

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Section: Discussionsupporting

confidence: 89%

Treatment of Acute Massive/Submassive Pulmonary Embolism.

Tayama

Ouchida

Teshima

et al. 2002

Circ J

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“…Pulmonary embolectomy is usually performed on CPB on warm beating heart without aortic crossclamping and cardioplegia delivery to avoid ischemic injury. During CPB, higher perfusion pressure should be maintained to reduce RV stunning [19]. Pulmonary embolectomy may be followed by lifethreatening complications like right or left ventricular failure, highpressure pulmonary oedema, pneumothorax, pulmonary infection, phrenic nerve injury, haemothorax and pulmonary infarction, and massive haemorrhagic pulmonary oedema secondary to reperfusion of the ischaemic and infarcted lung [10].…”

Section: Discussionmentioning

confidence: 99%

Anaesthetic Management of Massive Pulmonary Embolism: Case report and Review

Kumar¹

2014

J Clin Case Rep

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“…[2,3] On the other hand, with rapid diagnosis, careful patient selection, and improved surgical techniques, high survival rates of 89% at 10 months have been achieved. [24] Debates continue regarding whether or not the complexity of the surgical procedure is worth the risk and whether there are enough postoperative care facilities that have sufficient experience to care for patients who undergo this procedure.…”

Section: Discussionmentioning

confidence: 99%

“…[1] The operative mortality rate for a surgical embolectomy is stated to be 20-50% because it is usually performed on moribund patients and is often followed by prolonged resuscitation. [2,3] Because of this, a surgical embolectomy is seldom performed today, even though it is a viable option for the management of these patients. On the other hand, a surgical embolectomy performed in cases of APE has also been stated to reduce the progression to chronic thromboembolic pulmonary hypertension (CTPHT).…”

mentioning

confidence: 99%

Pulmonary embolectomy and thromboendarterectomy in seven cases

Hazan¹,

Şişli²,

Uğurlu³

et al. 2012

Turk Gogus Kalp Dama

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Amaç: Bu çalışmanın amacı, akut pulmoner emboli (APE) ve kronik tromboembolik pulmoner hipertansiyon (KTPHT) olgularının cerrahi ile belirgin olarak düzeldiklerini öngören kanıta dayalı veriler temelinde cerrahi sonrası seyir ile ilgili belirsizliği azaltmak ve bu olgularda cerrahi tedavi seçeneklerini dikkate alan doktorları cesaretlendirmektir. Ça lış ma pla nı: Bu gözlemsel ve geriye dönük gerçekleştirilen çalışmaya Şubat 2009 ile Ekim 2010 tarihleri arasında, APE ve KTPHT tanısı ile ameliyat edilen yedi olgu (3 erkek, 4 kadın; ort yaş 43.8±18.5 yıl; dağılım 25-73 yıl) dahil edildi. Hastaların ameliyat öncesi ve sonrası ortalama pulmoner arter basıncı (mPAP), New York Heart Association (NYHA) fonksiyonel sınıfı, yoğun bakım ünitesi (YBÜ) ve hastanede kalış süresi, demografik, klinik ve ameliyat özellikleri kaydedildi. Olgu sayısının yetersizliğinden dolayı istatistiksel analizler, parametrik olmayan testler ile yapıldı. Grupların karşılaştırılmasında Wilcoxon testi kullanıldı. Bul gu lar: Cerrahi sonrasında bütün hastalarda mPAP'da 20 mmHg (dağılım 5-53) düşüş sağlandı ve altıncı olgu hariç tüm olguların mPAP'ları, 30 mmHg'nın altına çekildi. Ameliyat öncesi ve sonrası mPAP'ları, sırasıyla 43 mmHg (dağılım 33-68) ve 23 mmHg (dağı-lım 15-37) idi. Bu durumda cerrahi sonrasında anlamlı bir düşüş elde edildi (z=-2.36; p=0.018). Buna ilaveten, cerrahi sonrasında hastanın NYHA sınıfındaki iyileşmesi 1 (dağılım 1-3) birimdi. Hastaların ameliyat öncesi ve sonrası NYHA sınıfları sırasıyla III (II-III) ve II (I-II) idi. Ameliyat sonrası NYHA sınıfındaki düşüş ile birlikte cerrahinin iyileştirme üzerine etkisi anlamlıydı (z=-2.26; p= 0.024). Yoğun bakım ünitesi ve hastanede ortalama kalış süreleri, sırasıyla üç (dağılım 2-14) ve 9.5 (dağılım 5-27) gündü. So nuç: Çalışma bulgularımıza göre, ayrıntılı bir ameliyat öncesi değerlendirme ve uygun hasta seçimi ile hekimler, cerrahi seçe-neğin kararında çekimser olmamalı ve hastaların yaşam kalitesini artırmak için çaba harcamalıdır.Anah tar söz cük ler: Akut pulmoner emboli; kronik tromboembolik pulmoner hipertansiyon; fonksiyonel kapasite; ortalama pulmoner arter basıncı; pulmoner tromboendarterektomi.Background:This study aims to reduce the uncertainity related to the prognosis after surgery of the acute pulmonary embolism (APE) and chronic thromboembolic pulmonary hypertension (CTPHT) patients, and to encourage physicians to consider surgical treatment options based on the evidence-based data which suggests that surgery offers the best chance for improvement in these patients. Methods: Between February 2009 and October 2010, seven cases (3 males, 4 females; mean age 43.8±18.5 years; range 25 to 73 years) who were operated on due to APE and CTPHT were included in this observational and retrospective study. The preand postoperative mean pulmonary artery pressure (mPAP), New York Heart Association (NYHA) functional class, and length of stay in the intensive care unit (ICU) and hospital along with the demographic, clinical and operational characteristics of the patients were r...

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Pulmonary embolectomy: A 20-year experience at one center

Cited by 187 publications

References 11 publications

Treatment of Acute Massive/Submassive Pulmonary Embolism.

Treatment of Acute Massive/Submassive Pulmonary Embolism.

Anaesthetic Management of Massive Pulmonary Embolism: Case report and Review

Pulmonary embolectomy and thromboendarterectomy in seven cases

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