Off-Pump Pulmonary Embolectomy

Abstract

Pulmonary embolism is a common clinical condition associated with high mortality. Surgical pulmonary embolectomy (SPE), despite having been in existence for over 100 years, is generally regarded as an option of last resort with high mortality rates. Prompt recognition of predictors of mortality, such as right ventricular stress on echocardiography, helps decision-making for immediate surgical pulmonary embolectomy prior to development of significant circulatory collapse, with promising results.We present a 71-year-old male, with recent intracranial bleed and acute massive bilateral pulmonary embolism. The patient underwent successful off-pump surgical pulmonary embolectomy.

Surgical pulmonary embolectomy: state of the art

“…Pulmonary artery embolectomy without extracorporeal circulation is now of historical value and can be performed using a mini-thoracotomy or sternotomy. Currently, such procedures are rarely practised; the literature contains descriptions of single cases or small case series [27][28][29][30]. However, they are used in selected patients, particularly those in whom heparinisation may increase the risk of bleeding, such as those with cerebrocranial trauma.…”