LEFT ANTERIOR THORACOTOMY FOR PULMONARY EMBOLECTOMY WITH 29-YEAR FOLLOW-UP

Pulmonary embolectomy is usually performed in cardiopulmonary bypass. In acute situations too much time can be lost in setting up and connec ting the pump oxygenator; this delay can cause cerebral damage in a pa tient with circulatory arrest. In such a situation left anterior thora cotomy can provide an ideal approach. An emergency thoracotomy can be performed in a few seconds. The lung automatically retracts. The phren ic nerve, pulmonary artery, and pericardium are clearly seen, and they outline the area for embolectomy. A case in which such an approach wa s successfully used is described. (Ann Thorac Surg 1998;66:1420-1) (C) 1998 by The Society of Thoracic Surgeons.