Surgery for massive pulmonary embolism.
Pulmonary embolectomies were performed in 30 patients from January 1973 until December 1991 in the University Hospital of Leuven. There was an 80% hospital survival. The late follow-up showed no recurrent pulmonary emboli. The preoperative haemodynamic status was the most important predictor for survival. Patients, under cardiopulmonary resuscitation or in profound cardiogenic shock before surgery, had a survival of only 50% while all other patients survived. Angiography, performed in only 23% of the cases, remained the most important diagnostic tool until the advent of transthoracic and transoesophageal echocardiography. Thrombolysis is an acceptable alternative in the stable patient, but pulmonary embolectomy is life-saving in the haemodynamically unstable patient and when thrombolysis is contraindicated.
Meyns
B
B
Department of Cardiac Surgery, Gasthuisberg University Hospital, Leuven, Belgium.
Sergeant
P
P
Flameng
W
W
Daenen
W
W
D000328:Adult; D000368:Aged; D001530:Belgium / Q000453:epidemiology; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality*; D011655:Pulmonary Embolism / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate