[Surgery in acute pulmonary embolism can be a life-saving therapeutic alternative. A follow up of surgically treated patients].

Acute pulmonary embolism occurs in about 10,000 people annually in Sweden, in more than 1000 of whom it has a fatal outcome. The clinical presentation may vary considerably, and a large number of patients with pulmonary embolism are still misdiagnosed. Most patients are treated with anticoagulants and some also with thrombolysis. During a 40-year period, 1957-1996, 12 patients underwent emergency pulmonary embolectomy at the Karolinska Hospital in Stockholm, Sweden. Of these, two (17%) died from anoxic brain damage within the first postoperative month. Four patients died 15-21 years after surgery. Six patients who were still alive at follow-up in 2003 were contacted 7-36 years after the embolectomy and were all in good health. In none of them had pulmonary embolism recurred, but two had suffered deep venous thrombosis. We conclude that emergency pulmonary embolectomy can be a lifesaving procedure, with a good long-term prognosis in patients who survive the early perioperative period.