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07:44
A Porcine Model of Acute Autologous Pulmonary Embolism
Published on: September 6, 2024
Acute pulmonary embolism: a current surgical approach
Antoine Digonnet1, Antoine Moya-Plana, Stéphane Aubert
1Department of Cardiovascular Surgery, Pitié Salpêtrière Hospital, University Pierre et Marie Curie, Paris Cedex 13, France.
Interactive Cardiovascular and Thoracic Surgery
|August 3, 2007
Summary
Surgical embolectomy offers improved outcomes for patients with sub-massive pulmonary embolism (PE). This procedure is a definitive treatment for PE, demonstrating excellent long-term results and serving as a viable alternative to other therapies.
Area of Science:
- Cardiovascular Surgery
- Pulmonary Medicine
- Interventional Cardiology
Background:
- Acute massive pulmonary embolism (PE) carries a high mortality rate, with existing treatments like thrombolysis and catheter embolectomy showing limitations.
- Surgical embolectomy is increasingly considered for hemodynamically stable patients with right ventricular dysfunction.
Purpose of the Study:
- To evaluate the surgical experience with pulmonary embolectomy over a ten-year period for both massive and sub-massive PE.
- To assess the outcomes and long-term results of surgical embolectomy in these patient populations.
Main Methods:
- A retrospective review of 21 patients who underwent pulmonary embolectomy between March 1995 and December 2005.
- Patients were divided into two groups: massive PE with cardiogenic shock (Group A, n=14) and sub-massive PE with stable hemodynamics and right ventricular dysfunction (Group B, n=7).
- Follow-up was conducted until December 2005 to assess survival and long-term outcomes.
Main Results:
- In Group A (massive PE), 43% of patients survived and were discharged.
- In Group B (sub-massive PE), all patients survived and were discharged.
- After a mean follow-up of 57±12 months, no late deaths related to PE were observed.
Conclusions:
- Surgical embolectomy is an effective primary treatment for sub-massive PE, yielding excellent long-term results.
- Rescue surgical embolectomy remains a crucial treatment for critically ill patients with massive PE.
- Surgical embolectomy presents a safe and definitive alternative or primary treatment option for (sub)massive pulmonary embolism, considering the risks associated with other interventions.
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