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Simple and secure thrombectomy involving the peripheral pulmonary arteries for acute pulmonary embolism
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  • Hanae Sasaki,
  • Ryosuke Kowatari,
  • Nirohiro Kondo,
  • Masahito Minakawa
Hanae Sasaki
Hirosaki Daigaku Igakubu Fuzoku Byoin

Corresponding Author:hsasaki@hirosaki-u.ac.jp

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Ryosuke Kowatari
Hirosaki Daigaku Igakubu Fuzoku Byoin
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Nirohiro Kondo
Hirosaki Daigaku Igakubu Fuzoku Byoin
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Masahito Minakawa
Hirosaki Daigaku Igakubu Fuzoku Byoin
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Abstract

Surgical pulmonary artery thrombectomy is a well-established emergency treatment for massive pulmonary embolism (PE) in which fibrinolysis or thrombolysis cannot happen. However, surgery for massive PE that requires peripheral pulmonary artery thrombus removal remains challenging. We established a simple and secure pulmonary artery thrombectomy method using cardiopulmonary bypass and cardiac arrest. In this procedure, the surgical assistant arm, typically used for coronary artery bypass grafting, is used to obtain a feasible working space during thrombectomy. We present seven consecutive massive PE cases treated with the present surgical method and successfully weaned from cardiopulmonary bypass or extracorporeal membrane oxygenation postoperatively. This procedure can be used to prevent right ventricular failure after surgery as surgeons can remove the thrombus up to the second branch of the pulmonary artery with direct vision.