Improved Outcome of Surgical Pulmonary Embolectomy by Aggressive Intervention for Critically Ill Patients

Fukuda, Ikuo; Taniguchi, Satoshi; Fukui, Kozo; Minakawa, Masahito; Daitoku, Kazuyuki; Suzuki, Yasuyuki

doi:10.1016/j.athoracsur.2010.10.086

Cited by 74 publications

(42 citation statements)

References 15 publications

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“…Mortality rates of 28-30% were reported in early studies of pulmonary embolectomy [4,8,9,10], with rates as high as 64% in patients presenting with hemodynamic instability or cardiac arrest [8,9]. The mortality rate for pulmonary embolectomy has declined in recent years, with some series reporting rates of <10% [1,3,4,11], likely due to the improved intraoperative and perioperative care and selection of patients. However, mortality rates for pulmonary embolectomy remain significantly higher in hemodynamically unstable patients [8] and even higher in those with preoperative cardiac arrest (33-85%) [1,4,5,10].…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Embolectomy in the Treatment of Submassive and Massive Pulmonary Embolism

Worku¹,

Gulkarov²,

Girardi³

et al. 2014

Cardiology

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Objectives: Significant improvements in outcomes after pulmonary embolectomy have resulted in a broadening of indications. We reviewed our experience with pulmonary embolectomy over the past 12 years with an emphasis on preoperative comorbidities and postoperative morbidity and mortality. Methods: All patients undergoing pulmonary embolectomy over the past 12 years at our institution were analyzed via retrospective chart review. Data on preoperative characteristics, operative procedures and postoperative outcomes were collected. Results: Twenty patients underwent pulmonary embolectomy between 1999 and 2011. The average age was 56 years (range 24-81) and 10 patients (50%) were female. All patients demonstrated right ventricular dysfunction and 19 (95%) demonstrated contraindications to thrombolysis. Twelve patients (60%) demonstrated intermittent hypotension, 4 (20%) required intubation and 3 (15%) demonstrated preoperative or intraoperative cardiac arrest. Survival to discharge was 95%. Conclusions: Pulmonary embolectomy has been shown to be safe and effective in the treatment of massive pulmonary embolism (PE). We achieved a 95% survival rate in a cohort of patients with significant comorbid status. Pulmonary embolectomy should be considered early in the therapeutic algorithm for patients with submassive PE presenting with right ventricular dysfunction to prevent progression. It can also be performed with good outcomes in those already suffering hemodynamic compromise.

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Section: Discussionmentioning

confidence: 99%

Pulmonary Embolectomy in the Treatment of Submassive and Massive Pulmonary Embolism

Worku¹,

Gulkarov²,

Girardi³

et al. 2014

Cardiology

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“…7 The current treatment options are haemodynamic and respiratory support, thrombolysis, surgical pulmonary embolectomy, percutaneous catheter embolectomy and fragmentation, anti-coagulation and venous filters. 8 Although thrombolysis is the mainstay of therapy in high-risk PE; it was reported that bleeding complication of TT is high. 9 Additionaly, since it might result with unsuccessful thrombolysis, rescue surgical pulmonary embolectomy might be a life-saving strategy.…”

Section: Discussionmentioning

confidence: 99%

Rescue Surgical Embolectomy in Acute Massive Pulmonary Embolism Presenting with Supraventricular Tachycardia

Dursunoğlu¹,

Dursunoğlu²,

Uğurlu³

et al. 2017

Turkiye Klinikleri J Med Sci

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“…При мультидисциплинарном подходе и индиви дуализированных показаниях к эмболэктомии до развития гемодинамического коллапса частота пе риоперационной летальности составляет ≤ 6 % [326,[328][329][330]. При преоперационном тромболизисе повышается риск кровотечений, но это не является абсолютным противопоказанием к хирургической эмболэктомии [331].…”

Section: хирургическая эмболэктомияunclassified

Pulmonary embolism: clinical guidelines of European Society of Cardiology (2014)*

Редакционная¹

2015

Pulʹmonologiâ (Mosk.)

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РезюмеВ данных Клинических рекомендациях суммированы все современные доказательства по диагностике и лечению тромбоэмболии легочной артерии (ТЭЛА). В отличие от предыдущей версии рекомендаций, в данном документе представлены упрощенные варианты клинических прогностических шкал, подробно рассмотрена стратификация риска летального исхода, включая промежуточные степени риска, представлены новые подходы к АКТ, в т. ч. системному тромболизису и катетерным методам лечения, терапии антагонистом витамина К, определено место новых пероральных антикоагулянтов в терапии ТЭЛА. Ключевые слова: рекомендации, тромбоэмболия легочной артерии, венозный тромбоз, шок, гипотензия, торакалгия, одышка, сердеч ная недостаточность, диагностика, антикоагулянты, тромболизис.

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Improved Outcome of Surgical Pulmonary Embolectomy by Aggressive Intervention for Critically Ill Patients

Cited by 74 publications

References 15 publications

Pulmonary Embolectomy in the Treatment of Submassive and Massive Pulmonary Embolism

Pulmonary Embolectomy in the Treatment of Submassive and Massive Pulmonary Embolism

Rescue Surgical Embolectomy in Acute Massive Pulmonary Embolism Presenting with Supraventricular Tachycardia

Pulmonary embolism: clinical guidelines of European Society of Cardiology (2014)*

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