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Pulmonary Embolism and the Indications for Embolectomy

Pulmonary Embolism and the Indications for Embolectomy Abstract THE RECENT increase in interest in the diagnosis and treatment of pulmonary embolism provides convincing evidence that most workers in the field do not share the view of Morrison1 concerning the possible obsolescence of pulmonary embolectomy. Much of the renewed interest undoubtedly stems from the application of cardiopulmonary bypass to the classic Trendelenberg2 operation. Since the descriptions of this modification by Sharp3 and Cooley,4 many surgeons have confirmed the increased success rate of embolectomy performed in this way. More successful embolectomies have been performed since 1961 than in the 37 years between Kirchner's initial success5 and 1961. Once the bypass circuit has been established, the operation becomes a rather straightforward one, a far cry from the heroic maneuvers of the past. There is no doubt that the heart-lung machine has greatly improved the treatment of this catastrophic disease. Many patients with massive pulmonary embolus die References 1. Morrison, M.C.T.: Is Embolectomy Obsolete? Brit J Dis Chest 57:187, 1963.Crossref 2. Trendelenberg, F.: Zur Operation der Embolie der Lungenarterien , Zib Chir 35:92, 1908. 3. Sharp, E.H.: Pulmonary Embolectomy; Successful Removal of a Massive Pulmonary Embolus With Support of Cardiopulmonary Bypass: Case Report , Ann Surg 156:1, 1962.Crossref 4. Cooley, D.A.; Beall, A.C., Jr.; and Alexander, J.K.: Acute Massive Pulmonary Embolism: Successful Surgical Treatment Using Temporary Cardiopulmonary Bypass , JAMA 177:283, 1961.Crossref 5. Kirschner, M.: Ein durch die Trendelenbergsche Operation geheilter Fall von Embolie der Art. Pulmonalis , Arch Klin Chir 133:312, 1924. 6. Stoney, W.S., Jr.; Jacobs, J.K.; and Collins, H.A.: Pulmonary Embolism and Embolectomy , Surg Gynec Obstet 116:292, 1963. 7. Orell, S.R.: Fate and Late Effects of Non-fatal Pulmonary Emboli , Acta Med Scand 172:473, 1962.Crossref 8. Marshall, R., et al: Immediate and Late Effects of Pulmonary Embolism by Large Thrombi in Dogs , Thorax 18:1, 1963.Crossref 9. Marable, S.A.; Winegarner, F.G.; and Moore, F.: Unpublished data. 10. Sautter, R.D., et al: Resolution of Massive Pulmonary Thromboembolism , JAMA 189:948, 1964.Crossref 11. Fred, H.L., et al: Rapid Resolution of Pulmonary Thromboemboli in Man: A Preliminary Report , Cardiov Res Center Bull 3:111, 1965. 12. Sabiston, D.B., and Wagner, A.N., Jr.: The Pathophysiology of Pulmonary Embolism: Relationships to Accurate Diagnosis and Choice of Therapy , J Thorac Cardiov Surg 50:339, 1965. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1966 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1966.01330020050007
Publisher site
See Article on Publisher Site

Abstract

Abstract THE RECENT increase in interest in the diagnosis and treatment of pulmonary embolism provides convincing evidence that most workers in the field do not share the view of Morrison1 concerning the possible obsolescence of pulmonary embolectomy. Much of the renewed interest undoubtedly stems from the application of cardiopulmonary bypass to the classic Trendelenberg2 operation. Since the descriptions of this modification by Sharp3 and Cooley,4 many surgeons have confirmed the increased success rate of embolectomy performed in this way. More successful embolectomies have been performed since 1961 than in the 37 years between Kirchner's initial success5 and 1961. Once the bypass circuit has been established, the operation becomes a rather straightforward one, a far cry from the heroic maneuvers of the past. There is no doubt that the heart-lung machine has greatly improved the treatment of this catastrophic disease. Many patients with massive pulmonary embolus die References 1. Morrison, M.C.T.: Is Embolectomy Obsolete? Brit J Dis Chest 57:187, 1963.Crossref 2. Trendelenberg, F.: Zur Operation der Embolie der Lungenarterien , Zib Chir 35:92, 1908. 3. Sharp, E.H.: Pulmonary Embolectomy; Successful Removal of a Massive Pulmonary Embolus With Support of Cardiopulmonary Bypass: Case Report , Ann Surg 156:1, 1962.Crossref 4. Cooley, D.A.; Beall, A.C., Jr.; and Alexander, J.K.: Acute Massive Pulmonary Embolism: Successful Surgical Treatment Using Temporary Cardiopulmonary Bypass , JAMA 177:283, 1961.Crossref 5. Kirschner, M.: Ein durch die Trendelenbergsche Operation geheilter Fall von Embolie der Art. Pulmonalis , Arch Klin Chir 133:312, 1924. 6. Stoney, W.S., Jr.; Jacobs, J.K.; and Collins, H.A.: Pulmonary Embolism and Embolectomy , Surg Gynec Obstet 116:292, 1963. 7. Orell, S.R.: Fate and Late Effects of Non-fatal Pulmonary Emboli , Acta Med Scand 172:473, 1962.Crossref 8. Marshall, R., et al: Immediate and Late Effects of Pulmonary Embolism by Large Thrombi in Dogs , Thorax 18:1, 1963.Crossref 9. Marable, S.A.; Winegarner, F.G.; and Moore, F.: Unpublished data. 10. Sautter, R.D., et al: Resolution of Massive Pulmonary Thromboembolism , JAMA 189:948, 1964.Crossref 11. Fred, H.L., et al: Rapid Resolution of Pulmonary Thromboemboli in Man: A Preliminary Report , Cardiov Res Center Bull 3:111, 1965. 12. Sabiston, D.B., and Wagner, A.N., Jr.: The Pathophysiology of Pulmonary Embolism: Relationships to Accurate Diagnosis and Choice of Therapy , J Thorac Cardiov Surg 50:339, 1965.

Journal

Archives of SurgeryAmerican Medical Association

Published: Aug 1, 1966

References