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June 1967

Recognition and Management of Massive Pulmonary EmbolismA Report of Successful Embolectomy

Author Affiliations

From the Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Maryland Hospital, Baltimore.

Arch Surg. 1967;94(6):884-890. doi:10.1001/archsurg.1967.01330120138027

SINCE Trendelenburg's original report in 1908, only a few successful pulmonary embolectomies have been reported.

A review of the world literature in 1961, revealed only 23 cases of successful pulmonary embolectomies.1 From 1961 to 1966, an additional 26 cases were reported with 15 instances where extracorporeal circulation was used.2-16

There were many failures prior to the first reported successful embolectomy.2,17 The principal reason for the paucity of successes is that most patients with massive pulmonary embolism die before diagnosis can be made or surgical treatment initiated. In a review of 271 autopsied patients who died of pulmonary embolism, 25% survived one hour, 22% for two hours, and only 17% lived six hours or longer. Of those surviving two hours, a correct diagnosis was made in only 50% of the cases.8 Rosenberg et al reviewing 100 instances of thromboembolism found that 62% died within the first hour.

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