title: [Surgery of central lung embolism: indications, mortality and early morbidity].
abstract: Between 1979 and 1988 massive pulmonary embolism (PE) was treated surgically in 36 patients with extracorporeal circulation (ECC). Circulation was stable in 11 patients and unstable in 25; in this group 9 had previous resuscitation because of cardiac arrest. There were 7/36 early deaths (19%); 5 of those patients had to be resuscitated prior to surgery. Deaths were caused mainly by cerebral edema or hemorrhage. Significant complications occurred in 8 patients (28%). Diagnoses of PE was made clinically in most cases; confirmation by echocardiography was useful. Pulmonary angiography was made in patients with uncertain diagnosis and stable circulation. Operation is indicated in patients with unstable circulation and proved central PE; it is advisible in patients with embolism of the main pulmonary artery or its major branches. Hospital mortality is very high when the patient has to be resuscitated preoperatively; in this group surgery should be performed only in younger patients with a short period of resuscitation. Interruption of the inferior vena cava should be performed to prevent recurrent PE.
authors.affiliation: Klinik für Herzgefässchirurgie, Universitätsspital Zürich.
authors.forename: E P
authors.initials: EP
authors.lastname: Bauer
authors.forename: L K
authors.initials: LK
authors.lastname: von Segesser
authors.forename: A
authors.initials: A
authors.lastname: Laske
authors.forename: M I
authors.initials: MI
authors.lastname: Turina
mesh_terms: D000328:Adult; D000368:Aged; D001929:Brain Edema / Q000401:mortality; D002423:Cause of Death; D002543:Cerebral Hemorrhage / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality*; D011655:Pulmonary Embolism / Q000601:surgery*; D012307:Risk Factors
vernacular_title: Chirurgie der zentralen Lungenembolie: Indikation, Mortalität und Frühmorbidität.