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

Figures & data

Table 1. Patients’ demographics and preoperative baseline characteristics.

Characteristics	All	Alive on 30^th day	Dead on 30^th day	p-value
Demographic data
Number of patients	49	35	14
Median age [years]	58 (IQR: 43–68)	55	65	0.147
Female	24 (49%)	17 (48.6%)	7 (50%)	0.999
Comorbidities
Chronic obstructive pulmonary disease (COPD)	3 (7%)	1	2	0.176
Diabetes mellitus	7 (16%)	5	2	0.999
Stroke	1 (2%)	1	0	0.999
TIA	4 (8%)	4	0	0.556
Arterial hypertension	24 (56%)	13	11	0.019
Atrial fibrillation (chronic or paroxysmal)	5 (4%)	3	2	0.60
Preoperative sinus rhythm	39 (80%)	30	9	0.171
BMI > 25 [kg/m^2]	20 (45%)	14	6	0.486
Symptoms
Chest pain	5 (10%)	2	3	0.999
Exertional dyspnea	9 (20%)	17	5	0.128
Dyspnea at rest	18 (39%)	16	2	0.049
Syncope	3 (6%)	2	1	0.999
Cardiogenic shock	23 (47%)	18	5	0.36
Cardiac arrest	7 (14%)	5	2	0.999
Risk factors
Major surgery during last 30 days	14 (29%)	9	5	0.503
Smoker	8 (16%)	5	3	0.667
Acute infection	6 (13%)	3	3	0.326
Trauma during last 30 days	5 (10%)	3	2	0.616
Steroid therapy	4 (8%)	4	0	0.55
Neurological disorder	3 (6%)	3	0	0.548
Myocardial infarction during last 30 days	2 (4%)	1	1	0.494
Right atrial catheter for hemodialysis	1 (2%)	1	0	0.999
Contraceptive pills	1 (2%)	1	0	0.999
Revlimid therapy	1 (2%)	1	0	0.999
Coagulation disturbances	8 (16%)	6	2	0.999
Acute pulmonary embolism in family history	3 (6%)	3	0	0.584
Factor V-Leiden	2 (4%)	2	0	0.999
Other genetically confirmed thrombophilia	2 (4%)	1	1	0.494
Acute pulmonary embolism in own medical history	1 (2%)	0	1	0.286
Confirmed deep vein thrombosis	16 (33%)	14	2	0.104
Failed thrombolysis	5 (10%)	4	1	0.999

Table 2. Intraoperative data, outcome and follow-up.

Characteristics	All	Alive on 30^th day	Dead on 30^th day	p-value
Intraoperative data
Median operation time [min]	176 (IQR: 134–290)	155	327	0.048
Median cardiopulmonary bypass (CPB) time [min]	82 (IQR: 59–155)	75	140	0.035
Operation on beating heart	22 (45.9%)	14	8	0.75
Aortic cross-clamp	27 (55.1%)	21	6	0.75
Median cross-clamp time [min]	39 (IQR: 27–53)	36	50	0.042
Median intraoperative body temperature [°C]	32 (IQR: 29.4–37.7)	32.2	30.9	0.132
IABP	2 (4%)	1	2	0.187
ECMO	1 (2%)	1	0	0.999
Intracardiac thrombi
Free-floating right heart thrombi	15 (31%)	10	5	0.735
Thrombosis of vena cava inferior	2 (4%)	1	1	0.494
Paradoxical embolism (left heart thrombi)	7 (10%)	5	2	0.999
Postoperative data
Mediastinal bleeding	3 (6%)	1	2	0.187
Acute renal failure requiring dialysis	2 (4%)	1	1	0.49
Wound infection	0	0	0	–
Stroke	1 (2%)	1	0	0.999
Median intubation time [hours]	30 (IQR: 12–118)	27	41	0.411
Reintubation	2 (4%)	0	2	0.074
Median ICU-Length of stay [days]	1 (IQR: 0-3)	2	0	0.021
Median hospital length of stay [days]	14 (IQR: 6–27)	16	11	0.063
30-day mortality	14 (29%)

Table 3. Predictors of mortality.

	30-day mortality			Long-term mortality
Characteristics	OR	95% CI	p-value	HR	95%CI	p-value
Demographic data
Age	1.034	0.99–1.08	0.133	1.03	0.99–1.62	0.062
Female	1.06	0.3–3.7	0.928	0.58	0.24–1.39	0.22
Comorbidities
Chronic obstructive pulmonary disease (COPD)	1.13	0.9–1.43	0.288	1.1	0.96–1.25	0.17
Diabetes mellitus	0.844	0.47–1.52	0.57	0.94	0.68–1.27	0.67
Stroke or transient ischemic attack	0	0	0.99	0.68	0.19–2.42	0.55
Arterial hypertension	7.19	1.35–38.24	0.021*	1.69	0.7–4.09	0.245
Atrial fibrillation (chronic or paroxysmal)	1.88	0.28–12.78	0.519	2.29	0.77–6.82	0.137
Preoperative sinus rhythm	0.3	0.06–1.45	0.134	0.39	0.15–1.01	0.053
BMI > 25 kg/m^2	0.81	0.44–1.5	0.507	0.754	0.44–1.29	0.303
Symptoms
Chest pain	4.65	0.68–31.9	0.118	2.83	0.941–8.528	0.064
Exertional dyspnea	0.59	0.16–2.18	0.427	0.855	0.35–2.07	0.73
Dyspnea at rest	0.193	0.04–1.01	0.051	0.209	0.061–0.717	0.013
Syncope	1.075	0.868–1.332	0.505	1.04	0.91–1.19	0.551
Cardiogenic shock	0.595	0.156–2.27	0.447	0.627	0.25–1.564	0.317
Cardiac arrest	1.33	0.2–8.7	0.764	1.36	0.42–4.2	0.598
Other factors
Major surgery during last 30 days	1.6	0.424–6.07	0.486	1.73	0.74–4.04	0.209
Smoker	1.65	0.32–8.54	0.551	1.56	0.56–4.34	0.398
Acute infection	3.1	0.54–17.87	0.206	2.99	1.09–8.22	0.034
Trauma during last 30 days	1.78	0.26–11.98	0.555	0.978	0.23–4.19	0.98
Steroid therapy	1.009	0.82–1.24	0.93	1.025	0.9–1.16	0.699
Neurological disorder	0	0	0.99	0.673	0.09–5.02	0.699
Myocardial infarction during last 30 days	2.6	0.15–44.9	0.5	1.26	0.17–9.4	0.82
Right atrial catheter for hemodialysis	0	0	0.99	2.3	0.3–17.29	0.419
Coagulation disturbances	0.806	0.14–4.57	0.87	0.044	0–45.9	0.378
Malignant tumor	1.6	0.38–6.65	0.518	1.8	0.73–4.42	0.202
Failed thrombolysis	0.81	0.25–2.56	0.715	0.62	0.23–1.7	0.356

Figure 1. Overall cumulative survival of the whole patient collective.