%0 Journal Article
%T Surgical embolectomy for acute massive pulmonary embolism: state of the art
%A Alessandra Iaccarino
%A Antonio De Bellis
%A Elio Iovine
%A Ernesto Greco
%A Giacomo Frati
%A Leonardo Schirone
%A Mizar DĄŻAbramo
%A Sebastiano Sciarretta
%A Wael Saade
%J SCIE-indexed Journal
%D 2018
%R 10.21037/jtd.2018.07.87
%X Venous thromboembolism (VTE) encompass both deep vein thrombosis (DVT) and pulmonary embolism (PE), representing in Western countries the third most frequent cardiovascular disease (after ACS and Stroke), and the third most common cause of hospital-related death. Every year, up to one million individuals are affected by DVT/PE, with a similar incidence in the USA and Europe (0.96¨C3.0 per 1,000 and 0.75¨C2.69 per 1,000, respectively) (1). It has been estimated that every year the number of VTE-related deaths is between 100,000 and 296,000 in the USA and 370,000 in Europe (2). Moreover, non-lethal PE may lead to chronic disease and disability (3). However, the exact incidence of VTE is unknown and difficult to determine because PE may remain asymptomatic and is often diagnosed after incidental finding. In fact, data are likely to be substantially higher since silent PE develops in up to 50% of patients with DVT and may remain undiagnosed for long (2). The severity of acute PE is assessed according to in-hospital or 30-day mortality in low-risk (LR), intermediate-risk (or submassive) and high-risk (or massive) acute PE. Among these, 7 out of 10 patients suffer from LR-PE and have preserved right ventricular function and absence of biomarkers of cardiovascular damage. Signs of right heart dysfunction and/or presence of biomarkers of cardiovascular damage, without persisting hypotension or shock, characterize the submassive EP form. Lastly, acute massive PE is the most severe form, characterized by signs of compromised respiratory or haemodynamic condition, with signs and symptoms of shock and a mortality rate that exceeds 20% irrespective of treatment. Early diagnosis is extremely important in massive PE since 70% of patients die within 1 hour from the onset of clinical signs of the disease because of a dramatic reduction of cardiac output finally leading to cerebrovascular complications and multiorgan failure (4)
%U http://jtd.amegroups.com/article/view/23266/html