Surgical Pulmonary Embolectomy Outcomes for Acute Pulmonary Embolism

Area of Science:

• Cardiology
• Thoracic Surgery
• Pulmonary Medicine

Background:

• Acute pulmonary embolism (PE) carries a high mortality risk.
• Surgical embolectomy is a potential treatment, but outcomes data are variable.
• This review systematically investigates patient outcomes following surgical embolectomy for acute PE.

Purpose of the Study:

• To evaluate patient outcomes after surgical embolectomy for acute pulmonary embolism.
• To synthesize data from existing studies on surgical embolectomy for PE.
• To assess the efficacy and safety of surgical embolectomy in managing acute PE.

Main Methods:

• Systematic review of 32 studies involving 936 patients.
• Data extraction included demographics, perioperative details, and outcomes.
• Pooled analysis of extracted data for comprehensive review.

Main Results:

• The study included patients with massive (83%) and submassive (13%) PE, many with hemodynamic instability (80%) and right ventricular dysfunction (82%).
• Mean operative time was 170 minutes, with 4% intraoperative mortality.
• In-hospital mortality was 16%, but overall 5-year survival reached 73%, with a significant reduction in postoperative systolic pulmonary artery pressure.

Conclusions:

• Surgical embolectomy is an acceptable treatment for acute pulmonary embolism.
• The procedure demonstrates favorable outcomes, including improved pulmonary artery pressure and long-term survival.
• Evidence supports surgical embolectomy as a viable therapeutic option for select PE patients.