Related Experiment Video
Updated: Jul 16, 2026
07:44
A Porcine Model of Acute Autologous Pulmonary Embolism
Published on: September 6, 2024
Surgical embolectomy in acute massive pulmonary embolism
Ahmad A Amirghofran1, Abbas Emami Nia, Ramin Javan
1Department of Cardiac Surgery, Shiraz University of Medical Sciences, Faghihi Hospital, Shiraz, Iran. amirghofranaa@yahoo.com
Asian Cardiovascular & Thoracic Annals
|March 28, 2007
Summary
Open pulmonary embolectomy is a highly effective treatment for acute massive pulmonary embolism. While cardiac arrest is a poor prognostic indicator, late diagnosis may allow for less aggressive clot removal, reducing complications.
Area of Science:
- Cardiology
- Thoracic Surgery
- Emergency Medicine
Background:
- Acute pulmonary embolism (PE) remains a significant cause of mortality despite advances in diagnosis and treatment.
- Therapeutic options for acute PE include anticoagulation, thrombolytic therapy, catheter embolectomy, and open pulmonary embolectomy.
- Open pulmonary embolectomy, once a last resort, is increasingly recognized for its effectiveness.
Purpose of the Study:
- To review the 7-year experience with open pulmonary embolectomy for acute massive pulmonary embolism.
- To evaluate the effectiveness and outcomes of surgical embolectomy in a specific patient cohort.
Main Methods:
- Retrospective review of 11 patients who underwent open pulmonary embolectomy for acute massive PE between 1997 and 2004.
- Diagnosis confirmed by spiral computed tomography (CT) or angiography.
- Analysis of patient demographics, risk factors, preoperative status, and postoperative outcomes.
Main Results:
- Eleven patients (7 male, mean age 45.6 years) underwent open embolectomy.
- Common risk factors included major surgery (46%), malignancy, and spinal cord injury.
- Preoperative cardiac arrest occurred in 3 patients, with 2 surviving.
- Late diagnosis with less aggressive clot evacuation was associated with reduced postoperative hemoptysis.
Conclusions:
- Open pulmonary embolectomy is the most effective treatment for acute massive pulmonary embolism.
- Preoperative cardiac arrest is the most significant negative prognostic factor.
- Less aggressive clot removal in late-diagnosed cases may minimize postoperative hemoptysis.
Related Concept Videos
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
01:29Pulmonary Embolism I: Introduction
Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
01:19Pulmonary Embolism I: Introduction
A blood clot, or thrombus, is a semi-solid mass composed of fibrin, platelets, and red blood cells. When it forms within a vessel, it can obstruct blood flow, known as thrombosis. If part of the clot detaches, it becomes an embolus that can travel and block distant vessels. When this occurs in the pulmonary arteries, it causes a condition known as pulmonary embolism (PE).Origin and ImpactMost often, the embolus originates from a thrombus in the deep veins of the lower limbs, a condition called...
01:27Pulmonary Embolism III: Nursing Management
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
01:29Venous Thrombosis III: Interprofessional Care
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
01:27Pneumothorax-II
Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Clinical Manifestations: