Author + information
- Chetan Pasrija,
- Isa Mohammed,
- Aakash Shah,
- Francis A. Brigante,
- Mehrdad Ghoreishi,
- James Gammie,
- Bartley Griffith and
- Zachary Kon
Background: Thrombus located distal to the primary pulmonary arteries has been previously viewed as a relative contraindication to surgical pulmonary embolectomy. We compared outcomes for surgical pulmonary embolectomy for submassive and massive pulmonary embolism in patients with central vs peripheral thrombus burden.
Methods: All consecutive patients (2011-2016) undergoing surgical embolectomy at a single center were reviewed. Based on computed tomographic angiography of each patient, central PE (CPE) was defined as any thrombus originating within the lateral pericardial borders (main or right/left pulmonary arteries). Peripheral PE (PPE) was defined as thrombus exclusively beyond the lateral pericardial borders, involving the lobar pulmonary arteries or distal.
Results: 70 patients with a median age of 53 years were identified: 52 (74%) with CPE and 18 (26%) with PPE. The incidence of PPE for surgical embolectomy increased from 25% in 2011 to 70% in 2016. Pre-operative risk stratification factors and outcomes are listed in Table 1. Overall 90-day survival was 94%, with 100% survival in patients with submassive PE in both cohorts (p=NS).
Conclusions: This single center experience demonstrates excellent overall outcomes for surgical pulmonary embolectomy with resolution of RV dysfunction, and comparable morbidity and mortality for CPE and PPE. When physiologically warranted, surgical pulmonary embolectomy for peripheral distribution of thrombus is both technically feasible and effective.
Room 147 B
Saturday, March 18, 2017, 8:25 a.m.-8:35 a.m.
Session Title: Highlighted Original Research: Pulmonary Hypertension and Venous Thrombo-embolic Disease and the Year in Review
Abstract Category: 35. Pulmonary Hypertension and Pulmonary Thrombo-embolic Disease
Presentation Number: 904-06
- 2017 American College of Cardiology Foundation