Surgical pulmonary embolectomy: mid-term outcomes.

Area of Science:

• Cardiology
• Thoracic Surgery
• Vascular Surgery

Background:

• Pulmonary embolism (PE) remains a significant cause of mortality despite prophylaxis.
• Massive PE carries a high risk of death.
• Surgical embolectomy is typically a last resort for PE treatment.

Purpose of the Study:

• To evaluate the outcomes of surgical embolectomy for massive pulmonary embolism.
• To assess the quality of life and functional status of survivors.

Main Methods:

• Retrospective analysis of prospectively collected data from 10 patients undergoing surgical embolectomy.
• Data included demographics, presenting symptoms, risk factors, and perioperative events.
• Follow-up included clinical review, quality of life questionnaires, echocardiography, and respiratory function testing.

Main Results:

• The most common symptom was syncope (70%), and immobilization was the most common risk factor (70%).
• 40% of patients experienced preoperative cardiac arrest, with 2 more arrests during anesthesia induction.
• Thirty-day mortality was 40%; however, survivors showed significant improvement in right ventricular function and reported good quality of life.

Conclusions:

• Surgical embolectomy can be effective in selected patients with massive PE.
• Survivors achieve good functional status (NYHA class I-II) and normal respiratory function.
• Long-term outcomes include improved right ventricular function and no recurrent thromboembolism with appropriate management.