The Annals of Thoracic Surgery, Vol 32, 28-32, Copyright © 1981 by The Society of Thoracic Surgeons
Pulmonary embolectomy
DM Glassford Jr, WC Alford Jr, GR Burrus, WS Stoney and CS Thomas Jr
During the past 10 years, 20 patients at St. Thomas Hospital had pulmonary
embolectomy; there were 12 survivors. Ten patients had a pulmonary
arteriogram prior to operation and, of these, there were 7 survivors. The
remaining 10 patients were seen with circulatory collapse and were taken
immediately to the operating room without definitive diagnostic studies.
Ten patients were undergoing cardiopulmonary resuscitation at the time of
the embolectomy and, of these, there were 5 long-term survivors. This
review indicates that immediate diagnostic studies, such as lung scan or
pulmonary arteriogram, should be undertaken as soon as the diagnosis of
pulmonary embolus is entertained. Patients with sudden collapse, in the
appropriate clinical setting, should be transported to the operating room
as soon as possible. It would also appear that patients who are
unresponsive to the usual measures of cardiopulmonary resuscitation are
still reasonable candidates for pulmonary embolectomy, and this may
represent their only change for survival. Patients in whom massive
pulmonary embolus is confirmed by angiography should be considered for
early pulmonary embolectomy despite a relatively stable hemodynamic and
clinical picture.
