Surgical Thromboembolectomy Under Cardiopulmonary Bypass

Objective. To analyze short-term and mid-term outcomes of surgical thromboembolectomy for pulmonary embolism. Material and methods. The study included 142 patients aged 39-76 years with acute pulmonary embolism. All ones underwent surgical thromboembolectomy, heparin therapy or thrombolytic therapy. We assessed echocardiography parameters before treatment, in short- and mid-term period after recovery. Results. No difference in mortality was found (p=0.240). Surgical treatment was followed by significantly lower pulmonary artery pressure in short-term period compared to heparin and thrombolysis groups (p<0.001), as well as in mid-term period compared to heparin therapy (p=0.08). In early period, there was significantly decrease in right ventricular dimensions after surgical treatment (p<0.001) and heparin therapy (p=0.004). Surgical treatment was followed by significantly lower tricuspid insufficiency compared to other methods in mid-term period (p<0.001). LV ejection fraction was higher after heparin therapy (p=0.005), while cardiac output in mid-term period was significantly higher after surgical treatment (p<0.001). Conclusion. Surgical treatment of acute pulmonary embolism may be preferable and provide comparable or superior hemodynamic effect in short- and mid-term period.