Outcome of pulmonary embolectomy for acute pulmonary thromboembolism: analysis of 32 patients from a multicentre registry in Japan.

OBJECTIVE Massive pulmonary embolism is relatively rare but a potentially life-threatening condition. The purpose of this study was to analyse the outcome of pulmonary embolectomy in registered data from the Japanese Society of Pulmonary Embolism Research (JaSPER). METHODS From 1994 to 2006, 1661 cases of acute pulmonary embolism were registered in the JaSPER database. Retrospective analysis of 32 patients undergoing pulmonary embolectomy was conducted. The overall incidence of pulmonary embolectomy was 1.9% [95% confidence interval (CI): 1.8-3.2%]. The mean age of patients was 57 years and 66% were female. RESULTS Overall mortality of pulmonary embolectomy was 18.8% [95% CI: 5.2-25.6%]. Most of the patients had massive or submassive pulmonary thromboembolism, and three patients experienced cardiopulmonary arrest before embolectomy. Ten patients received preoperative percutaneous cardiopulmonary bypass, and mortality was 30% in this subgroup. CONCLUSIONS Pulmonary embolectomy is an effective therapeutic option for patients with massive or submassive pulmonary embolism. Prompt triage of patients with haemodynamic instability is important.