A Report on Emergent Pulmonary Embolectomy

Document Type: Original Article

Authors

1 Cardiac Surgeon, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Anesthesiologist, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Resident of Anesthesiology, Department of Anesthesiology, Mashhad University of Medical Sciences, Mashhad, Iran

4 Master in Medical Education, Mashhad, Iran

Abstract

Introduction: Pulmonary embolism is one of the leading causes of mortality in patients.The mortality rate of this disease can be significantly reduced with appropriate treatment. Surgical intervention can be highly effective for the treatment of acute massive pulmonary embolism. This article presents a report on the experience of acute pulmonary embolectomy.
Materials and Methods: Demographic data, rate of mortality, as well as surgical and post-operative complications were recorded and analyzed.
Results: In general, 12 patients with mean age of 60±13.39 year were included in the study. None of the patients had significant arrhythmia during the surgery, but 25% suffered from post-operative arrhythmia. Moreover, electrical cardioversion was administered to 8% of the patients, 8% received pharmaceutical interventions, and the rest of the patients sustaining arrhythmia (9%) survived with specific metabolic correction.
The diagnosis of acute pulmonary embolism was correct in 100% of the patients, with 33.3% of the cases suffering from this disease due to recent surgeries. In 41.6% of the patients, blood clots were observed in the pulmonary artery, right atrium, and right ventricle. The three-month follow-up of the patients showed that 83.3% of the cases were alive. There were two cases of mortality, one of which occurred at the end of surgical procedure and the other one happened in the intensive care unit.
The results of independent t-test did not indicate any significant relation between mortality and ejection fraction of the patients (P=0.189). Moreover, there were not any significant differences between the patients’ pre- and post-operative laboratory tests (P˃0.05). Nonetheless, hemoglobin and hematocrit levels were significantly different pre- and post-operation (P=0.0001).
Conclusion: Our data suggest that acute pulmonary embolism can be treated successfully with favorable outcome and a mortality rate of approximately 16.6%, if evaluation and diagnosis are done as soon as possible in patients who require surgical intervention.

Keywords


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