Emergency Surgery for Acute Pulmonary Embolism

According to the current guidelines for acute pulmonary embolism in Japan, it is standard to perform surgical thrombectomy only after introducing percutaneous cardiopulmonary support (PCPS) for circulatory collapse. We experienced 2 cases of surgical thrombectomy without using PCPS. The 1st patient was a 49-year-old man. Computed tomography (CT) on admission revealed a thrombus in the main trunk of the pulmonary artery. He developed severe dyspnea and drop of consciousness after admission, and underwent emergency surgical thrombectomy. The 2nd patient was a 52-year-old man whose levels of consciousness and arterial oxygenation rapidly declined after admission. His CT revealed thrombi in the main trunk of the pulmonary artery, and he underwent emergency thrombectomy. Both patients had a history of diabetes and obesity. At our institute, we actively choose surgical thrombectomy for cases in which a thrombus is revealed in the main trunk of the pulmonary artery on CT and for cases in which abnormal symptoms and/or signs such as impaired consciousness and oxygenation develop.