Follow-up of Surgically Treated Patients with Massive Pulmonary Embolism - With Reference to 12 Operated Patients

Summary

Since 1978, 17 patients have undergone surgery for massive pulmonary embolism in our department. Twelve patients survived and have been followed up for between 2 and 31 months postoperatively (mean 16 months).

Reassessment of these patients included exercise tolerance test, pulmonary function test, perfusion scan, right heart catheterization and coagulation screening.

Two survivors present major sequelae, namely vascular pruning and definite signs of pulmonary hypertension, The other 10 patients have minimal or no residual vascular occlusion, but show a high incidence of minor abnormalities: slight rise in pulmonary arterial pressure during exercise (3 cases), small angiographic and scintigraphic defects (5 cases), arterial hypoxemia (5 cases) and disturbances of pulmonary function (10 cases). Systemic venous problems were found to be frequent and to be a handicap in 5 cases, and an abnormal pattern of response to exercise was observed in 4 patients. These disturbances may be related to ligation of the vena cava. Various derangements of coaguiation were found in all but one of the patients.

Key words

Pulmonary embolism - Surgery - Cardiopulmonary bypass