[Therapeutic effects of thromboembolectomy and caval Günther filter insertion in chronic pulmonary embolism]

Two cases of chronic-stage pulmonary embolism which had occurred at least one month before the operation were presented. Pulmonary thromboembolectomy under the cardiopulmonary bypass was performed and followed by the insertion of Günther filter to prevent recurrence of embolism. Both cases revealed severe obstruction occupying over 50% of the pulmonary arteries which were presented by the remarkable increase of pulmonary arterial systolic pressures up to 100 and 80 mmHg respectively. After thrombectomy the pulmonary artery pressure declined to 45 and 28 mmHg, even though the pulmonary embolism was in subchronic state. The respiratory symptoms and abnormal findings on the ECG and chest X-ray were also improved. Since the phlebothrombosis of the inferior limb might be the cause of pulmonary embolism, the insertion of the filter in the inferior vena cava was thought to be indispensable for the prevention of recurrence.