Acute pulmonary embolectomy with cardiopulmonary bypass support

Deep venous thrombosis and pulmonary thromboembolism remain major sources of patient morbidity and mortality.The authors present the case of a 55-year-old man with a massive pulmonary embolism and subsequent hemodynamic decompensation who was successfully treated by open pulmonary embolectomy supported with cardiopulmonary bypass.Indications for embolectomy and patient selection as well as technical considerations are discussed.(Key words: Venous thrombosis, pulmonary embolism, embolectomy, cardiopulmonary bypass)Deep venous thrombosis and pulmonary embolism remain major causes of patient mortality and morbidity despite advances in diagnosis and therapy_!Acute, massive pulmonary emboli may produce hemodynamic instability and profound systemic and cerebral hypoxemia.2We present the case of a 55-year-old man in whom a massive pulmonary embolus developed after the institution of thrombolytic therapy for iliofemoral venous thrombosis.The patient was successfully treated with open pulmonary embolectomy with the support of a pump-oxygenator.We discuss the technique of pulmonary embolectomy as well as considerations in patient selection.