Surgical treatment of acute pulmonary embolism—a 12-year retrospective analysis

Figures & data

Table I. Contraindications for thrombolysis.

Absolute:

– Hemorrhagic stroke or unknown stroke at any time

– Ischemic stroke in preceding 6 months

– Central nervous system damage or neoplasms

– Recent major trauma/surgery/head injury in preceding 6 month

– Known bleeding

Relative:

– Transient ischemic attack in preceding 6 month

– Oral anticoagulant therapy

– Pregnancy or within 1 week post-partum

– Non-compressible punctures

– Traumatic resuscitation

– Refractory hypertension

– Advanced liver disease

– Infective endocarditis

– Active peptic ulcer

Stated by the European Society of Cardiology (1)

Table II. Predisposing risk factors for development of PE (N =33).

	n (%)
Trauma	4 (12)
Cancer	4 (12)
Major surgery	7 (21)
Deep vein thrombosis	3 (9)
Partus	1 (3)
Medical illness	4 (12)
– COPD	1
– Livercirrosis	1
– Inflammatory bowel disease	2
Thrombophilia	1 (3)
Anticontraceptive treatment	2 (6)
Prior pulmonary embolism	1 (3)
Unknown	6 (18)

Table III. Indication for surgical treatment of PE (N =33).

	n (%)
High risk PE	26 (79)
Intermediate risk PE	7 (21)
Myxoma	2 (6)
Patent foramen ovale	2 (6)
Atrial thrombi	1 (3)
Failure of thrombolysis	6 (18)
– Thrombolysis × 1	3 (9)
– Thrombolysis × 2	3 (9)
Contraindications for thrombolysis	13 (39)
Cardiogenic shock	6 (18)
Need for ventilatory support	8 (24)
Cardiac arrest	1 (1)

Figure 1. Kaplan–Meier survival. Cumulative survival after surgical embolectomy for acute pulmonary embolism.

Figure 2. Embolic clot removed from the left pulmonary artery. Photo: The author.

Torbicki A, Perrier A, Konstantinides S, Agnelli G, Galie N, Pruszczyk P, . Guidelines on the diagnosis and management of acute pulmonary embolism: the task force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology (ESC). Eur Heart J. 2008;18:2276–2315.

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