Twenty-year results of surgical pulmonary thromboembolectomy in acute pulmonary embolism

Sabreen Mkalaluh, Marcin Szczechowicz, Matthias Karck, G. Szabó

Research output: Contribution to journalArticle

Abstract

Background. Acute massive pulmonary embolism is often a life-threatening condition and should be treated immediately. The aim of this study was to investigate risk factors and clinical outcomes of patients undergoing emergency pulmonary embolectomy for acute massive pulmonary embolism. Methods. We evaluated 49 patients undergoing emergency pulmonary embolectomy in our institution between 1995 and 2015, retrospectively. We reviewed preoperative conditions and risk factors, surgical complications, postoperative courses, predictors of mortality and long-term survival. Results. At the time of presentation, the median patients’ age was 58 years. Preoperatively, seven (14%) individuals had cardiac arrest and required cardiopulmonary resuscitation. At the time of surgery, other 23 (47%) patients presented with cardiogenic shock. The most common risk factor for development of pulmonary embolism was major surgery in the last 30 days (29%, n = 14). Five (10%) patients received systemic thrombolysis preoperatively. The median cardiopulmonary bypass (CPB) time was 82 minutes. The median length of stay in the intensive care unit and in hospital were 1 and 14 days, respectively. Postoperative complications included revision as a consequence of mediastinal bleeding (6%, n = 3), stroke (2%, n = 1), and acute renal failure requiring temporary dialysis (4%, n = 2). The 30-day mortality was 29% (n = 14) with four (8%) cases of death during the surgery. The one-, five- and 15-year survival rates were 65%, 63%, and 57%, respectively. Conclusion. Pulmonary embolectomy can be performed in high-risk patients with massive pulmonary embolism with acceptable clinical outcome and good long-term survival.

Original languageEnglish
JournalScandinavian Cardiovascular Journal
DOIs
Publication statusPublished - Jan 1 2019

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Pulmonary Embolism
Embolectomy
Lung
Emergencies
Survival
Cardiogenic Shock
Mortality
Cardiopulmonary Resuscitation
Heart Arrest
Cardiopulmonary Bypass
Acute Kidney Injury
Intensive Care Units
Dialysis
Length of Stay
Survival Rate
Stroke
Hemorrhage

Keywords

  • Pulmonary embolism
  • right heart thrombus
  • surgical embolectomy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Twenty-year results of surgical pulmonary thromboembolectomy in acute pulmonary embolism. / Mkalaluh, Sabreen; Szczechowicz, Marcin; Karck, Matthias; Szabó, G.

In: Scandinavian Cardiovascular Journal, 01.01.2019.

Research output: Contribution to journalArticle

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