Pulmonary embolectomy for a patient of chronic pulmonary embolism

Chronic pulmonary embolism is resistant to medicinal treatment. This is a report of the successful operation for chronic pulmonary embolism. A 29-year-old man suffered from dyspnea attack twice half a year in spite of intensive anticoagulant therapy. Cardiac catheterization showed pulmonary hypertension of 72/25 mmHg, mean 42 mmHg. Pulmonary angiogram demonstrated emboli in the right pulmonary artery and pulmonary perfusion scintigram revealed large perfusion defect in the right lung. The patient underwent pulmonary embolectomy after the total cardiopulmonary bypass. After surgery, blood gas showed an increased PaO2 from 65 to 77 mmHg. Pulmonary artery pressure decreased to 39/12 mmHg, mean 23 mmHg. Pulmonary arteriogram showed increased pulmonary vascular beds and pulmonary scintigram showed an increased perfusion in the right lung. The patient has been free from symptom and a half year after surgery.