[The clinical analysis of 54 cases for the surgical treatment of pulmonary embolism].
OBJECTIVE
To evaluate the results of surgical procedures for pulmonary embolism.


METHODS
Fifty-four patients of pulmonary embolism received surgical treatment from October 1994 to June 2007, of which 9 were acute pulmonary embolism underwent pulmonary embolectomy and 45 patients were chronic thromboembolic pulmonary hypertension (CTEPH) underwent pulmonary thromboendarterectomy.


RESULTS
The mortality rate was 44.4% in acute pulmonary embolism group and 13.3% in CTEPH group (P < 0. 05). Thirteen patients had residual pulmonary hypertension and 23 patients had severe pulmonary reperfusion injury postoperatively. The pulmonary artery systolic pressure changed from (89.4 +/- 36.3) mm Hg (1 mm Hg =0.133 kPa) preoperative to (55.6 +/- 22.4) mm Hg postoperative. The pulmonary vascular resistance changed from (89. 7 +/- 56.7) kPa L(-1) S(-1) preoperative to (38.9 +/- 31.1) kPa L(-1) S(-1) postoperative. The arterial partial pressure of oxygen changed from (52. 3 +/- 6.7 ) mm Hg preoperative to (87.6 +/- 6.5) mm Hg postoperative. The arterial oxygen saturation changed from (88.9 +/- 4.5)% preoperative to (95.3 +/- 2.8 )% postoperative (P < 0.05). With the follow-up of (41.8 +/- 36.4) months, there were 4 patients died. According to NYHA, there were 28 patients for class I , 10 patients for class II and 2 patients for class III. According to Kaplan-Meier survival curve, the 3-year, 4-year, 5-year and 8-year survival rate were (97.1 +/- 2.8 )%, (94.0 +/- 4.1)%, (90.8 +/- 5.2)% and (85.0 +/- 7.3)% respectively. Linear rate of bleeding and thromboembolic related to anticoagulation were 0. 63% patient-years and 0. 62% patient-years respectively.


CONCLUSIONS
The operational mortality of acute pulmonary embolism is significantly higher than CTEPH, and the mid-long term survival rate is agreeable and the complication rate related to anticoagulation is relatively low.
Cardiac Surgery Department, Beijing Anzhen Hospital, Capital Medical University (BAZH-CMU), Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China. ganhuili@hotmail.com
Hui-Li
HL
Gan
Jian-Qun
JQ
Zhang
Zhao-Guang
ZG
Zhang
Qi-Wen
QW
Zhou
Yi
Y
Luo
Jun-Sheng
JS
Mu
Sheng-Xun
SX
Wang
Si-Hong
SH
Zheng
Xiang-Feng
XF
Zhang
Shuang
S
Liu
Guang-Fa
GF
Zhu
D000293:Adolescent; D000328:Adult; D000368:Aged; D017128:Embolectomy / Q000379:methods*; D004691:Endarterectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000601:surgery; D011655:Pulmonary Embolism / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult