An Approach to the Surgical Treatment of Pulmonary Embolism

Robert W.M. Frater, MD; Ira J. Schneider, MD; Neville Kaplan, MD; Perry Tirschwell, MD
JAMA. 1966;196(1):11-16. doi:10.1001/jama.1966.03100140065017.
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In a series of cases of acute pulmonary embolism, the value of hemodynamic and angiographic studies as aids to diagnosis and prognosis and the planning of therapy is illustrated. In three patients hemodynamic changes indicative of a potentially fatal outcome were produced by massive embolization on one side accompanied by previous pulmonary disease or minor embolization on the other side. These changes were restored to normal by unilateral embolectomy without the aid of cardiopulmonary bypass. The possibility of using a unilateral extraction of emboli as a part of open-chest resuscitative procedures in the patient who has had sudden massive "fatal" embolism was seen in two further patients in whom this was done although without survival.


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