Open Surgery for Pulmonary Thromboembolism
Acute massive pulmonary embolism (PE) is a life threatening condition requiring quick diagnosis and intervention. The mortality rate in this acute entity is high despite progress in therapeutically strategies. Acute PE is the third most common cause of death among hospitalized patients. Currently, multidisciplinary teams with cardiovascular surgeons’ involvement have introduced again the surgical embolectomy on cardiopulmonary bypass for high risk patients with PE and also for selected patients with intermediate-high risk, particularly if thrombolysis is contraindicated or failed. There is also recent evidence data that supports prompt multidisciplinary approach and individualized indication of surgery before hemodynamic collapse, while the mortality rates are of 6% or less. Complete removal of thrombotic material from pulmonary arteries is the best predictor to avoid persistent pulmonary artery hypertension. Acute pulmonary embolectomy on cardiopulmonary bypass is safe and it has good and long-lasting results in patients with severe right ventricular dysfunction.
KeywordsPulmonary embolism Pulmonary embolectomy Cardiopulmonary bypass Thrombolysis Deep vein thrombosis Pulmonary thromboembolism
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