Pulmonary Embolectomy for Acute Pulmonary Embolism: A Word of Caution

• Published in: Annals of Vascular Diseases Vol. 13; no. 1; pp. 96 - 99
• Main Authors: Inui, Tomohiko, Ishida, Keiichi, Kohno, Hiroki, Matsuura, Kaoru, Ueda, Hideki, Tamura, Yusaku, Watanabe, Michiko, Inage, Yuichi, Yakita, Yasunori, Matsumiya, Goro
• Format: Journal Article
• Language: English
• Published: Japan The Editorial Committee of Annals of Vascular Diseases 25.03.2020; Japanese College of Angiology / The Japanese Society for Vascular Surgery / Japanese Society of Phlebology
• Subjects: acute pulmonary embolism; Case Report; chronic thromboembolic pulmonary hypertension; pulmonary embolectomy; chronic thromboembolic pulmonary hypertension; pulmonary embolectomy; acute pulmonary embolism
• ISSN: 1881-641X; 1881-6428
• DOI: 10.3400/avd.cr.19-00089

Pulmonary embolectomy is an effective treatment of acute pulmonary embolism (APE) but not for chronic pulmonary thromboembolism. We described surgical experience of two patients with APE in preexistent unidentified chronic pulmonary thromboembolism. One patient who presented with severe hypoxia but stable hemodynamics underwent successful pulmonary endarterectomy for proximal organized thrombus instead of pulmonary embolectomy. The other patient who required extracorporeal membrane oxygenation for severe hypoxia developed right heart failure because of residual distal organized thrombus after pulmonary embolectomy. Clinical and radiographical presentation of APE in chronic pulmonary thromboembolism mimics APE, and thus, candidates of pulmonary embolectomy should be carefully selected.