Tips and tricks for rapid sequence pulmonary embolectomy in patient with massive pulmonary thromboembolism

  1. Do not become agitated
  2. Perform TTE as soon as possible
  3. Adminster systemic Heparin full dose
  4. Don’t become disappointed neither depressed even in non beating Heart contonue massage
  5. Perform median sternotomy while doing massage continuously
  6. Commence open cardiac massage and in most cases adminster epi either NE or Vasopressin into the aortic root
  7. Heart Starts beating
  8. Cannulation bicaval and commence CPB
  9. Ask your Perfusionist to correct ABG abd Hb of the patient
  10. With Zeraatian’s line of surgery single incision perform embolectomy calmly without damaging pulmonary artery branches
  11. Try to wean and go home !!!

Ask your anesthesiologist to protect brain during all steps
Sam Zeraatiannejaddavani Attending professor of Cardiovascular Surgery IUMS and transplantation faculty and CEO if RMRC
Darius Suraki Azad MD research lecturer in RMRC and CEO of ADKWA medical