Peripheral Distribution of Thrombus Does Not Affect Outcomes After Surgical Pulmonary Embolectomy

Abstract

This single-center experience demonstrates excellent overall outcomes for surgical pulmonary embolectomy, with resolution of right ventricular dysfunction and comparable morbidity and mortality for central and peripheral PE. In an experienced center and when physiologically warranted, surgical pulmonary embolectomy for peripheral distribution of thrombus is technically feasible and effective.

Invited Commentary

“…In the accompanying article, Pasrija and colleagues [4] challenge the often-declared mantra that pulmonary embolism beyond the pericardium is a relative contraindication to surgical pulmonary embolectomy. This small, but important study of 70 patients, of which 18 (26%) presented with peripheral pulmonary embolism, demonstrates excellent outcomes at 90 days, with no difference for peripherally vs centrally located emboli.…”

Occult Chronic Thromboembolic Disease in Patients Presenting for Surgical Pulmonary Embolectomy

“…The increasing utilization of surgical embolectomy for acute PE makes the diagnosis of acute on chronic disease particularly salient. [5][6][7][8][9] Timely and reliable diagnosis of acute on chronic disease is critical for the appropriate selection of intervention. Interventions designed to treat acute thrombus will not successfully resolve the chronic component of the disease, potentially resulting in residual right ventricle (RV) dysfunction and associated symptoms.…”