Simple and secure thrombectomy involving the peripheral pulmonary
arteries for acute pulmonary embolism
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.