Emergency surgical embolectomy can be a life-saving intervention for patients presenting with severe hypotension and large right-sided intracardiac thrombi.
May support surgical embolectomy in select unstable PE cases with right-heart thrombi; hypothesis-generating and leaves open need for prospective confirmation.
An acutely ill hypotensive man was evaluated and found to have a large, mobile, right-sided intracardiac mass on two-dimensional echocardiography; the latter aids in differentiating thromboemboli, tumor, and vegetation. Owing to a severe drop in blood pressure, the patient underwent emergency surgery with cardiopulmonary bypass wherein large masses of organized clots were re moved from the right atrium, right ventricle, and left and right pulmonary arteries. Pulmonary embolectomy with exploration of all right-sided cardiac chambers in this patient who had deteriorated clinically proved life-saving.
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Sheldon et al. (1990) studied this question.
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