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[Pulmonary embolectomy for massive pulmonary embolism]

S Shimokawa1, H Toyohira, H Iwamura

  • 1Second Department of Surgery, Kagoshima University Faculty of Medicine, Japan.

[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai
|February 1, 1995
PubMed
Summary

Surgical pulmonary embolectomy for massive pulmonary embolism is rare but feasible. Prompt diagnosis, cardiopulmonary support, and timely surgery improve survival, though complications like hemorrhage can occur.

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Area of Science:

  • Cardiovascular Surgery
  • Pulmonary Medicine
  • Critical Care Medicine

Context:

  • Massive pulmonary embolism (PE) requiring surgical intervention is infrequent in Japan.
  • This study reviews four surgical pulmonary embolectomy cases over six years.

Purpose:

  • To analyze the surgical challenges and clinical outcomes of pulmonary embolectomy for massive PE.
  • To identify factors critical for improving surgical results in these rare cases.

Summary:

  • Four patients (41-72 years) underwent pulmonary embolectomy; three survived with improvement. Preoperative shock and cardiac arrest complicated cases.
  • Diagnosis involved pulmonary arteriography (PAG) and clinical assessment. Thrombolysis was ineffective; surgery occurred 4 hours to 5 days post-onset.
  • Complications included low output syndrome, respiratory failure, and hemorrhage. Careful technique and inferior vena cava filters are suggested.

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Impact:

  • Highlights the need for rapid diagnosis, cardiopulmonary support, and early surgical decisions to enhance outcomes for massive PE.
  • Emphasizes careful surgical technique to avoid pulmonary artery injury and suggests vena cava filters for recurrence prevention.