Yonsei Med J.  2008 Dec;49(6):973-977. 10.3349/ymj.2008.49.6.973.

Open Pulmonary Thromboembolectomy in Patients with Major Pulmonary Thromboembolism

• Lee S
• Song SW
• Yi G
• Youn YN
• Yoo KJ
• Chang BC

• KMID: 1782946
• DOI: http://doi.org/10.3349/ymj.2008.49.6.973

Abstract

PURPOSE
We retrospectively analyzed open pulmonary thromboembolectomy in patients with acute and chronic pulmonary thromboembolism. MATERIALS AND METHODS: Between August 1990 and May 2005, 12 consecutive patients with acute and chronic pulmonary thromboembolism underwent open pulmonary thromboembolectomy at Yonsei Cardiovascular Center. Their mean age was 47.5 years, and 7 of the patients were female. Among 12 patients, 5 had acute onset, and 7 had chronic disease, and 9 patients were associated with deep venous thrombosis. Extent of pulmonary embolism was massive in 3 patients with hemodynamic instability, and submassive in 8 patients. Preoperative echocardiogram revealed elevated right ventricular pressure in all patients, and 7 patients were in NYHA functional class III or IV. Pulmonary thromboembolectomy was performed in all patients under total circulatory arrest. RESULTS: There were 2 hospital deaths (16.7%). Among the patients who survived, mean right ventricular pressure was decreased significantly from 64.3mmHg to 34.0mmHg with improvement of NYHA functional class. CONCLUSION: Open pulmonary thromboembolectomy is thought to be an immediate and definitive treatment for massive pulmonary embolism with optimal results. Even though operative mortality is still high, early diagnosis and immediate surgical intervention in highly selective patients may improve the clinical outcome.

Keyword

Pulmonary thromboembolism; thromboembolectomy

MeSH Terms

Adult
Aged
*Embolectomy/mortality
Female
Humans
Korea/epidemiology
Male
Middle Aged
Prognosis
Pulmonary Embolism/mortality/physiopathology/*surgery
Retrospective Studies
Vena Cava Filters

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