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J Thorac Cardiovasc Surg 2006;131:484-486
© 2006 The American Association for Thoracic Surgery

Brief Communication

Inflow occlusion pulmonary embolectomy in the modern era of cardiac surgery

Joseph L. Bobadilla, MD, Christopher H. Wigfield, MD, Paramjeet S. Chopra, MD *

Department of Cardiothoracic Surgery, University of Wisconsin, Hospital and Clinics, Madison, Wis.

Received for publication June 16, 2005; accepted for publication August 8, 2005.

* Address for reprints: Paramjeet S. Chopra, MD, University Hospital, Department of Cardiothoracic Surgery, 600 Highland Ave, Madison, WI 53792-3236 (Email: chopra@surgery.wisc.edu).

The first 20% of the full text of this article appears below.


Figure 1
Drs C. Wigfield, P. Chopra, and J. Bobadilla (left to right)


Pulmonary embolism (PE) continues to be a significant cause of morbidity and mortality. It is estimated that nearly 200,000 to 300,000 PEs are diagnosed annually in the United States: approximately 1 per 1000 persons per year. Additionally, PE is associated with 50,000 to 100,000 deaths annually. 1 Go Operative intervention, although rarely performed, is indicated in patients with massive embolism resulting in hemodynamic instability. Massive embolism is defined as a PE associated with systolic pressures less than 90 mm Hg or a 40 mm Hg or greater decrease from baseline for longer than 15 minutes. 2 Go Patients with such embolic burden often rapidly progress to refractory hypotension and subsequent cardiopulmonary arrest. This patient population may benefit from surgical embolectomy.

Clinical Summary

We present a case of a 48-year-old black woman who presented with severe cerebral hemorrhage. She subsequently developed a pulmonary embolus and experienced worsening hypoxemia and a precipitous decrease in mean arterial pressure (>40 mm Hg). There was no identifiable septic or primary cardiac cause for this abrupt change. Echocardiographic evaluation showed signs of . . . [Full Text of this Article]




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