Original articleAdult cardiacSurgical Embolectomy for Acute Massive and Submassive Pulmonary Embolism in a Series of 115 Patients
Section snippets
Material and Methods
With approval from our Partners Human Research Committee, we identified 115 consecutive patients who underwent surgical pulmonary embolectomy at our institution between October 1999 and September 2013. We use a multidisciplinary approach to evaluate all patients with suspected or confirmed PE that includes the early involvement of cardiology, cardiac surgery, and chest radiology teams. The diagnosis of acute PE was made by chest computed tomography angiography in 96 of 115 patients (83%; Fig 1
Results
The study population had a mean age of 59 years (± 13) and included 43 women (37.4%). The most common presenting symptom was dyspnea (98 of 115, 85%), and less common were chest pain (28 of 115, 24%) and syncope (18 of 115, 16%). Mean body mass index was 29.5 ± 6.2 kg/m2. Preoperative risk factors are listed in Table 1.
Comment
According to current American Heart Association and American College of Chest Physicians guidelines, thrombolysis remains the mainstay choice for acute, massive PE, as well as for select patients with submassive PE 9, 10. The principal finding of our study, one of the largest to date, is that surgical pulmonary embolectomy is safe and effective, and should play a broader role in the initial treatment of acute PE. We achieved an overall operative mortality of 6.9% by intervening in patients with
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