Surgical embolectomy in treating acute massive pulmonary embolism

Abstract

Objective: To evaluate the outcome of patients with massive pulmonary thrombo-embolism. Methods: The retrospective study comprised data of pulmonary embolectomy done on patients with anatomically extensive pulmonary embolism with severe right ventricular dysfunction, symptomatic hypotension or those unresponsive to thrombolytic therapy. Medical records of 16 cases with massive pulmonary embolism that had undergone embolectomy at the Madani Heart Center in Tabriz, Iran, between January 2003 and July 2011 were included. SPSS 16 was used for statistical analysis. Results: Of the 16 patients, 10(62.5%) were women, and 6(37.5%) were men. The mean age of the patients was 53 +/- 17.75 years. There were 2(12.55%) deaths, while 14(87.5%) were discharged from hospital and followed up for at least 2 years. Immediate pre-discharge echocardiographic evaluation revealed dramatic decrease in the right ventricular systolic pressure with a mean of 93.61 +/- 15.48 mm/Hg and 50.25 +/- 19. 85 mm/Hg of pre-and post-embolectomy respectively (p<0.001). However, it never dropped so much as to be considered normal. Conclusion: The high proportion of survival suggests embolectomy shall be used in cases of massive pulmonary thrombo embolism.