Pulmonary embolectomy in the management of massive pulmonary embolism

This paper reports the Alfred Hospital experience with pulmonary embolectomy in the management of 61 patients with massive pulmonary embolism over a 26-year period. All operations were performed on cardiopulmonary bypass. Mortality was 16% in patients who had not sustained a cardiac arrest preoperatively (n=44), and 59% in those who had arrested (n=17). Pulmonary embolectomy for massive pulmonary embolism can be performed safely and may be the treatment of choice in the patient with circulatory instability. In the patient who has sustained a cardiac arrest from pulmonary embolism, embolectomy offers the only hope in a desperate situation.