Embolectomy for chronic pulmonary embolism and hypertension.

The case of a 31-year-old Negro who had had two admissions to the hospital at which pulmonary emboli were diagnosed is reported. On his third admission with chest pain, hemoptysis, and dyspnea, chest roentgenograms revealed increased pulmonary vascular markings on the right and a prominent pulmonary artery which was sharply cut off. ECG changes were typical of pulmonary artery obstruction and pulmonary scan revealed a small perfusion defect in the lower lobe of the right lung and complete absence of perfusion in the left lung. The left pulmonary artery was occluded. An organized thrombus was removed from the left pulmonary artery and from most of its distal branches. Good back flow ensued, and 10 months after operation the patient was well except for some edema of the leg. A discussion of the problems and indications for pulmonary embolectomy is offered.