Acute Pulmonary Thromboembolism: 14 Years of Surgical Experience
10.5090/kjtcs.2019.52.2.78
- Author:
Jiye PARK
1
;
Sang Hyun LIM
;
You Sun HONG
;
Soojin PARK
;
Cheol Joo LEE
;
Seung Ook LEE
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine, Suwon, Korea. dbricasa@aumc.ac.kr
- Publication Type:Original Article
- Keywords:
Pulmonary embolism;
Outcomes;
Surgery, complications;
Cardiopulmonary bypass;
Echocardiography
- MeSH:
Acute Kidney Injury;
Blood Pressure;
Cardiopulmonary Bypass;
Echocardiography;
Embolectomy;
Follow-Up Studies;
Hemorrhage;
Humans;
Hypoxia, Brain;
Mortality;
Postoperative Complications;
Pulmonary Embolism;
Retrospective Studies;
Survivors;
Tricuspid Valve Insufficiency
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2019;52(2):78-84
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Pulmonary thromboembolism (PTE) is a life-threatening disease with high mortality. This study aimed to assess the outcomes of surgical embolectomy and to clarify the sustained long-term effects of surgery by comparing preoperative, postoperative, and long-term follow-up echocardiography outcomes. Of 22 survivors, 21 were followed up for a mean (median) period of 6.8±5.4 years (4.2 years). METHODS: We retrospectively reviewed 27 surgical embolectomy cases for massive or submassive acute PTE from 2003 to 2016. Immediate and long-term follow-up outcomes of surgical embolectomy were assessed on the basis of 30-day mortality, long-term mortality, postoperative complications, right ventricular systolic pressure, and tricuspid regurgitation grade. RESULTS: The 30-day and long-term mortality rates were 14.8% (4 of 27) and 4.3% (1 of 23), respectively. Three patients had major postoperative complications, including hypoxic brain damage, acute kidney injury, and endobronchial bleeding, respectively (3.7% each). Right ventricular systolic pressure (median [range], mm Hg) decreased from 62.0 (45.5–78.5) to 31.0 (25.7–37.0, p<0.001). The tricuspid valve regurgitation grade (median [range]) decreased from 1.5 (0.63–2.00) to 0.50 (0.50–1.00, p<0.05). The improvement lasted until the last echocardiographic follow-up. CONCLUSION: Surgical embolectomy revealed favorable mortality and morbidity rates in patients with acute massive or submassive PTE, with sustained long-term improvements in cardiac function.
