{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T19:40:50Z","timestamp":1791574850684,"version":"4.3.4"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T00:00:00Z","timestamp":1705449600000},"content-version":"vor","delay-in-days":16,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Surgical pulmonary embolectomy is rarely used for the treatment of massive acute pulmonary embolism. The aim of this study was to assess the incidence and outcomes of this operation by undertaking a retrospective analysis of a large national registry in the UK.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>All acute pulmonary embolectomies performed between 1996 and 2018 were captured in the National Institute of Cardiovascular Outcomes Research central database. Trends in the number of operations performed during this interval and reported in-hospital outcomes were analysed retrospectively. Multivariable logistic regression was used to identify independent risk factors for in-hospital death.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>All 256 patients treated surgically for acute pulmonary embolism during the study interval were included in the analysis. Median age at presentation was 54 years, 55.9% of the patients were men, 48.0% had class IV heart failure symptoms, and 37.5% had preoperative cardiogenic shock. The median duration of bypass was 73\u2005min, and median cross-clamp time was 19\u2005min. Cardioplegic arrest was used in 53.1% of patients. The median duration of hospital stay was 11 days. The in-hospital mortality rate was 25%, postoperative stroke occurred in 5.4%, postoperative dialysis was required in 16%, and the reoperation rate for bleeding was 7.5%. Risk-adjusted multivariable analysis revealed cardiogenic shock (OR 2.54, 95% c.i. 1.05 to 6.21; P = 0.038), preoperative ventilation (OR 5.85, 2.22 to 16.35; P &amp;lt; 0.001), and duration of cardiopulmonary bypass exceeding 89\u2005min (OR 7.82, 3.25 to 20.42; P &amp;lt; 0.001) as significant independent risk factors for in-hospital death.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Surgical pulmonary embolectomy is rarely performed in the UK, and is associated with significant mortality and morbidity. Preoperative ventilation, cardiogenic shock, and increased duration of bypass were significant predictors of in-hospital death.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjs\/znae003","type":"journal-article","created":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T08:15:11Z","timestamp":1705479311000},"source":"Crossref","is-referenced-by-count":12,"title":["Incidence and outcomes of surgical pulmonary embolectomy in the UK"],"prefix":"10.1093","volume":"111","author":[{"given":"Amerikos","family":"Argyriou","sequence":"first","affiliation":[{"name":"Bristol Heart Institute, Bristol Royal Infirmary, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hunaid","family":"Vohra","sequence":"additional","affiliation":[{"name":"Bristol Heart Institute, Bristol Royal Infirmary, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Chan","sequence":"additional","affiliation":[{"name":"Bristol Heart Institute, Bristol Royal Infirmary, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eltayeb Mohamed","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Bristol Heart Institute, Bristol Royal Infirmary, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cha","family":"Rajakaruna","sequence":"additional","affiliation":[{"name":"Bristol Heart Institute, Bristol Royal Infirmary, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianni Davide","family":"Angelini","sequence":"additional","affiliation":[{"name":"Bristol Heart Institute, Bristol Royal Infirmary, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6759-7719","authenticated-orcid":false,"given":"Daniel Paul","family":"Fudulu","sequence":"additional","affiliation":[{"name":"Bristol Heart Institute, Bristol Royal Infirmary, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,1,17]]},"reference":[{"key":"2024061207423497000_znae003-B1","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1056\/NEJMra0907731","article-title":"Acute pulmonary embolism","volume":"363","author":"Agnelli","year":"2010","journal-title":"N Engl J Med"},{"key":"2024061207423497000_znae003-B2","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.1161\/CIRCRESAHA.115.306841","article-title":"Global burden of thrombosis: epidemiologic aspects","volume":"118","author":"Wendelboe","year":"2016","journal-title":"Circ Res"},{"key":"2024061207423497000_znae003-B3","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1160\/TH07-03-0212","article-title":"Venous thromboembolism (VTE) in Europe. 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