Unresolved pulmonary embolism: the value of surgical management with extensive thrombo-endarterectomy

In a small but definite number of patients with pulmonary embolism, either gradual resolution of the embolus does not occur or recurrent showers of emboli follow the acute onset, leading to a state of chronic pulmonary hypertension. Two new cases treated surgically without the use of cardiopulmonary bypass are described. The results were excellent in both cases with relief of the dyspnoea and an improvement in the PO2, a result that has been documented in the follow-up of 2-6 years. The only definite treatment of this chronic obstructive pulmonary hypertension is pulmonary thrombo-endarterectomy.