Ahmed Elsayed Mahmoud
A young active surgeon , interested in all adult cardiac surgery fields
Chapters authored
Pulmonary Embolism
Pulmonary embolism is sudden occlusion of pulmonary arteries, usually by a clot arising in the lower limb veins. The majority of pulmonary emboli are silent, and it is only when the embolus burden is substantial that the patient becomes symptomatic. Mortality after an acute, major thromboembolic episode is significantly high. Pulmonary embolism which causes hemodynamic instability is usually associated with occlusion of more than 50% of the pulmonary vasculature. Associated severe pulmonary hypertension may cause cardiac arrest. The precipitation of RV failure is also affected by the degree of preexisting right ventricular hypertrophy or dilatation, tricuspid valve regurgitation, and the presence of coronary artery disease. Aggressive therapy is needed in this subgroup of patients. Unfortunately, surgical embolectomy is seldom even entertained as an option in the management of these patients. A critical assessment of the data reveals that there is in fact a definite place for surgical therapy in the management of massive pulmonary embolism.
Part of the book: Embolic Diseases