TY - JOUR ID - 83994 TI - SURGICAL EMBOLECTOMY IN ACUTE MASSIVE PULMONARY EMBOLISM JO - Iranian Heart Journal JA - IHA LA - en SN - AU - AMIR GHOFRAN, A.A. AD - DEPT. OF CARDIAC SURGERY, FAGHIHI HOSPITAL, SHIRAZ UNIVERSITY OF MEDICAL SCIENCES, SHIRAZ, IRAN Y1 - 2007 PY - 2007 VL - 8 IS - 1 SP - 6 EP - 12 KW - Background- Acute pulmonary embolism is a serious condition and despite diagnostic and therapeutic advances KW - mortality is still high. Anticoagulation KW - THROMBOLYTIC THERAPY KW - catheter embolectomy and open pulmonary embolectomy are therapeutic options. Surgical embolectomy was considered the management of last resort KW - but recent studies have shown the effectiveness of this therapeutic modality. Methods- We reviewed our 7-year experience with pulmonary embolectomy in patients with acute massive pulmonary embolism from 1997to 2004. Results- Eleven patients underwent KW - pulmonary embolism occurred after major surgery. Two patients were diagnosed with malignancy and spinal cord injury. No risk factor was detected in 4 patients. The diagnosis was made by spiral CT scan alone in 4 and by angiography in 7 patients. Card DO - N2 - Background- Acute pulmonary embolism is a serious condition and despite diagnostic and therapeutic advances, mortality is still high. Anticoagulation, thrombolytic therapy, catheter embolectomy and open pulmonary embolectomy are therapeutic options. Surgical embolectomy was considered the management of last resort, but recent studies have shown the effectiveness of this therapeutic modality.Methods- We reviewed our 7-year experience with pulmonary embolectomy in patients with acute massive pulmonary embolism from 1997to 2004.Results- Eleven patients underwent open embolectomy. Seven (63.6%) were male and the average age was 45.6. In 5 patients (45.4%), pulmonary embolism occurred after major surgery.Two patients were diagnosed with malignancy and spinal cord injury. No risk factor was detected in 4 patients. The diagnosis was made by spiral CT scan alone in 4 and by angiography in 7 patients. Cardiac arrest occurred in 3 patients pre-operatively. Two patients survived after pre-operative cardiac arrest.Conclusion- Open pulmonary embolectomy is the most effective method of treatment of acute massive pulmonary embolism. CT scan is the best diagnostic modality and cardiac arrest is the worst prognostic factor. Less aggressive clot evacuation in patients who are diagnosed late seems to be effective in minimizing post-operative hemoptysis. UR - http://journal.iha.org.ir/article_83994.html L1 - http://journal.iha.org.ir/article_83994_d105fe1c2ad80c358b8a0f67ba176fde.pdf ER -