Workshop on the Treatment of Pulmonary Embolism-Which Patients Do I Choose for Surgery? Dr. Jay Giri and Discussion

Which Patients Do I Choose for Surgery? Dr. Jay Giri and Discussion

Video Transcription

Video Summary

The discussion revolves around acute surgical embolectomy’s role in treating high-risk pulmonary embolism (PE). Despite historical challenges with poor outcomes due to techniques like the Trendelenburg procedure, modern advances like cardiopulmonary bypass and ECMO (Extracorporeal Membrane Oxygenation) have improved outcomes in selected cases. The conversation underscores the importance of patient selection, emphasizing that it's about finding suitable patients who aren't post-arrest or extremely high-risk. Experts note that the real challenge lies in resources and personnel, as few centers can conduct such surgeries. The participants advocate for comprehensive shock programs that integrate acute PE protocols and emphasize ECMO's role, suggesting it's favored over lytics for patients with escalating pressor requirements. However, challenges exist in the broader adoption of surgical treatment due to logistics, personnel, and expertise disparities across centers. The debate also touches on ethical considerations and decision-making strategies in the face of patient comorbidities.

Keywords

acute surgical embolectomy

pulmonary embolism

ECMO

patient selection

shock programs

ethical considerations