PULMONARY EMBOLECTOMY FOR ACUTE MASSIVE PULMONARY EMBOLISM

Due to the development of systemic thrombolysis the surgical pulmonary embolectomy became a rare procedure reserved for a small group of patients only.Considering hemodynamic instability and obvious critical conditions of the patients, the morbidity and mortality remains very high despite modern peri and postoperative care.

Between November 1998 and September 2006, 8 patients ( 4 male, 4 female, mean age 52,3) underwent pulmonary embolectomy in our centre. All procedures were performed under cardio-pulmonary bypass. In 3 cases pulmonary thromboembolism was associated with paradoxical embolism. 3 patients died, the mortality was 37,5%.

The indications, optimal timing and post-operative care are discussed.