Off-pump open pulmonary embolectomy for major bilateral pulmonary emboli: report of a case

Acute massive or submassive pulmonary artery thromboembolism causes sudden hemodynamic deterioration, warranting immediate surgery. We report the case of a 67-year-old woman who suffered a syncopal attack resulting in shock, 3 weeks after undergoing orthopedic surgery. Preoperative radiologic imaging studies, including a lung perfusion scan, chest scan, and venography, showed a major bilateral pulmonary artery embolism (PE) originating from a leg vein. An inferior vena cava filter was inserted preoperatively during the venography. We performed an open pulmonary embolectomy without cardiopulmonary bypass by using a submammary trans-sternal bilateral thoracotomy approach. The patient recovered uneventfully and has been well for 13 months.