Limbourg P, Just H, Lang K F, Satter P
Dtsch Med Wochenschr. 1977 Apr 29;102(17):649-54. doi: 10.1055/s-0028-1104948.
In ten patients successful embolectomy after acute massive pulmonary embolism was performed. Clinical symptoms included circulatory arrest and shock as well as collaps, syncope and dyspnoe. Pulmonary angiography regularly showed massive, bilateral emboli. In 9 patients more than one half of the pulmonary artery system was involved (perfusion defect more than 50%). Right heart catheterization demonstrated pulmonary hypertension in all cases. In 8 patients the pulmonary artery mean pressure (PAm) exceeded 30 mm Hg. In 9 patients there were signs of right heart failure (RVEDP more than 11 mm Hg). At recatheterization 6 to 30 (mean 19) days after operation using cardiopulmonary bypass there was a marked improvement of pulmonary angiograms, which were normal in 3 cases. PAm decreased from 34.3 mm Hg to 14.6 mm Hg postoperatively and RVEDP from 14.4 to 5.1 mm Hg (p less than 0.001). These results confirm, that pulmonary embolectomy leads to a good functional results.
对10例急性大面积肺栓塞患者成功实施了栓子切除术。临床症状包括循环骤停、休克以及虚脱、晕厥和呼吸困难。肺血管造影常显示双侧大面积栓子。9例患者肺动脉系统受累超过一半（灌注缺损超过50%）。右心导管检查显示所有病例均有肺动脉高压。8例患者肺动脉平均压（PAm）超过30 mmHg。9例患者有右心衰竭体征（右心室舒张末期压力超过11 mmHg）。在使用体外循环术后6至30天（平均19天）再次进行导管检查时，肺血管造影有显著改善，3例结果正常。术后PAm从34.3 mmHg降至14.6 mmHg，右心室舒张末期压力从14.4降至5.1 mmHg（p<0.001）。这些结果证实，肺栓子切除术可带来良好的功能效果。
