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October 1967

Pulmonary Embolectomy

Author Affiliations

From the Department of Surgery, University of Toronto and Toronto General Hospital.

Arch Surg. 1967;95(4):576-584. doi:10.1001/archsurg.1967.01330160046006

EMBOLECTOMY for massive pulmonary embolus has been a challenge to the surgeon for many years. In 1908, Trendelenburg proposed the direct removal of thrombi from the pulmonary artery.1 The first successful pulmonary embolectomy was done by Kirschner in 19242 and Steenburg and associates3 reported the first successful pulmonary embolectomy in the United States in 1958. Other notable contributions have been made by Allison,4 Sharp,5 and Sabiston.6 In 1961, Cooley demonstrated the efficacy of temporary cardiopulmonary bypass in the management of massive pulmonary embolism.7

In spite of these advances, however, a large number of patients still die of pulmonary emboli. Phear8 has stated that 50% of people with a massive embolus die in the hospital and of those who survive only two thirds will return to normal lives while the remainder are disabled by cor pulmonale, dyspnea, and rhythm changes. Incorrect diagnosis, the

Trendelenburg, F.:  Ueber die Operative Behandlung der: Emboli der Lungenarterie , Arch Klin Chir 86:686, 1908.
Kirschner, M.:  Ein Durch die Trendelenburgsche: Operation Geheilter Fal von Embolic der Art Pulmonalis , Arch Klin Chir 133:312, 1924.
Steenburg, R.W., et al:  A New Look at Pulmonary Embolectomy , Surg Gynec Obstet 107:214, 1958.
Allison, P.R.; Dunnill, M.S.; and Marshall, R.:  Pulmonary Embolism , Thorax 15:273, 1960.Article
Sharp, E.H.:  Pulmonary Embolectomy: Successful Removal of a Massive Pulmonary Embolus With the Use of Extracorporeal Circulation: Case Report , Ann Surg 156:1, 1962.Article
Sabiston, D.C., Jr.; Durham, N.C.; and Wagner, H.N., Jr.:  The Pathophysiology of Pulmonary Embolism: Relationships to Accurate Diagnosis and Choice of Therapy , J Thorac Cardiov Surg 50:339, 1965.
Cooley, D.A.; Beall, H.C., Jr.; and Alexander, J.K.:  Acute Massive Pulmonary Embolism: Successful Surgical Treatment Using Temporary Cardio-pulmonary Bypass , JAMA 177:283, 1961.Article
Phear, D.:  Pulmonary Embolism: A Study of Late Prognosis , Lancet 2:832, 1960.Article
Couves, C.M.; Sproule, B.J.; and Fraser, R.S.:  Acute Pulmonary Embolism: Successful Embolectomy Using Cardiopulmonary Bypass , Canad Med Assoc J 86:1056, 1962.
Paneth, M.:  Pulmonary Embolectomy: An Analysis of 12 Cases , J Thorac Cardiov Surg 53:77, 1967.