Early and late results after surgery for massive pulmonary embolism
Details
Serval ID
serval:BIB_82DB0C6E0D03
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Early and late results after surgery for massive pulmonary embolism
Journal
Thoracic and Cardiovascular Surgeon
ISSN
0171-6425
Publication state
Published
Issued date
12/1991
Peer-reviewed
Oui
Volume
39
Number
6
Pages
353-6
Notes
Journal Article --- Old month value: Dec
Abstract
Between 1978 and 1990 emergency pulmonary embolectomy with the aid of extracorporeal circulation (ECC) was performed for massive pulmonary embolism (PE) in 44 patients (19-73 yrs; 49 +/- 15 yrs). Cardiopulmonary circulation was stable in 16/44 patients but unstable in 28/44; of the latter, 15 had undergone previous cardiopulmonary resuscitation due to cardiac arrest. Diagnosis of PE was obtained clinically in 15/44 patients, by angiography in 13/44, by echocardiography in 10/44, and by perfusion scintigraphy of the lung in 6/44 patients. There were 9/44 (20%) postoperative deaths. Early mortality was significantly higher in previously resuscitated patients (p less than 0.05). There were 2/36 (6%) late deaths. Actuarial survival was 75% after 4 yrs and 71% after 8 yrs. 77% or 35 survivors were in NYHA-class I and 23% in NYHA-class II after a mean follow-up of 4.6 yrs. Pulmonary embolectomy is indicated in patients with central PE and shock; it is advisable in patients with embolism of the main pulmonary artery or its major branches or in patients with contraindication to thrombolysis. Intraoperative insertion of a vena cava filter is recommended for prevention of recurrent embolism. Preoperative resuscitation and duration of ECC are predictors for early death.
Keywords
Actuarial Analysis
Emergencies
Extracorporeal Circulation
Female
Follow-Up Studies
Hospital Mortality
Humans
Male
Middle Aged
Postoperative Complications/*mortality
Pulmonary Embolism/mortality/*surgery
Resuscitation
Time Factors
Vena Cava Filters
Pubmed
Web of science
Create date
14/02/2008 15:19
Last modification date
20/08/2019 15:42