Pulmonary embolectomy is a surgical procedure that removes a blood clot from the pulmonary artery. The pulmonary artery is the main blood vessel that carries oxygenated blood from the heart to the lungs. The procedure is typically performed when the blood clot, also known as an embolus, causes a blockage in the pulmonary artery and disrupts the normal flow of blood to the lungs.
What is an Embolectomy?
Embolectomy is a highly specialized and complex procedure that is typically performed by a team of surgeons, including cardiothoracic surgeons and interventional radiologists. It is usually done on an emergency basis, as a pulmonary embolism (a blood clot in the lungs) can be life-threatening if left untreated.
Who Has to Undergo an Embolectomy?
Patients who may need to undergo an embolectomy include those who have suffered from a pulmonary embolism or those at high risk of developing one. That may include individuals who have a history of deep vein thrombosis (DVT), have recently undergone major surgery, are pregnant, or have pre-existing medical conditions, such as cancer or heart disease.
How Is a Pulmonary Embolectomy Done?
The steps involved in a pulmonary embolectomy will depend on the patient’s specific needs and the blood clot’s location and size. In some cases, the procedure may be performed using minimally invasive techniques, such as through a small incision in the chest or through a catheter inserted into a blood vessel in the leg. In more complex cases, a more traditional open surgery may be necessary.
Here is a brief overview of how the process works:
- Pre-surgery preparation: Before the procedure, the patient will need to undergo a series of tests and assessments to determine their overall health and whether they are a candidate for an embolectomy. It may include blood tests, imaging tests, and a physical examination.
- Anesthesia: Before the surgery begins, the patient will be given general anesthesia to put them to sleep and ensure that they do not feel any pain during the procedure.
- Accessing the blood clot: There are several ways surgeons can access the blood clot in the pulmonary artery. It may include making a small incision in the chest and opening the ribcage to access the artery or inserting a catheter (a thin, flexible tube) into a blood vessel in the leg and guiding it through the body to the site of the clot.
- Removing the blood clot: Once the surgeons have access to the blood clot, they will use specialized instruments to remove it. It may involve using a mechanical device to break up the clot and suction it out or using a device to trap the clot and remove it in one piece.
- Closing the incision: Once the blood clot has been removed, the surgeons will close the incision or remove the catheter and cover the incision site with a sterile dressing.
- Recovery: After the surgery, the patient will be moved to the intensive care unit (ICU) for close monitoring. They will be given pain medication and other medications to help prevent further blood clots from forming. Physical therapy may also be recommended to help the patient regain strength and mobility.
It is important to note that every patient is different, and the specific steps involved in a pulmonary embolectomy may vary based on the individual case.
After a pulmonary embolectomy, patients will typically need to take several medications to help prevent further blood clots from forming and manage any pain or discomfort. These may include:
- Blood thinners: These medications, also known as anticoagulants, help prevent blood clots. Common blood thinners include Warfarin, Heparin, and Dabigatran.
- Pain medication: Patients may have to take over-the-counter or prescription pain medication to help manage any discomfort they experience after the surgery.
- Antibiotics: To help prevent infection, patients may be given antibiotics or other medications.
- Medications to manage other medical conditions: Depending on the patient’s specific medical history, they may need to continue taking medications for other conditions, such as hypertension or diabetes.
Many patients also have to undergo physical therapy to regain strength and mobility. It is important to follow your healthcare team’s advice regarding post-operative care.
Risks and Complications
As with any surgical procedure, embolectomy has risks and complications. These include bleeding, infection, and damage to the blood vessels or surrounding tissues. In rare cases, the procedure may not successfully remove the blood clot, or the patient may develop additional blood clots after the surgery.
It is crucial to discuss the risks and benefits of a pulmonary embolectomy with your doctor before undergoing the procedure.
Non surgical pulmonary embolectomy and 1 Case example – these have to be covered
Pulmonary embolectomy is a complex and specialized procedure that is usually performed on an emergency basis and involves a team of surgeons. While there are risks and complications associated with embolectomy, it can be a life-saving procedure for patients suffering from a blood clot in the lungs.
Dr. C Raghu is an eminent cardiologist with extensive experience in interventional cardiology. If you or anyone you know has been diagnosed with a pulmonary embolism, reach out to Dr. Raghu to understand your treatment options.