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Lessons learned on a new procedure: Non-Sternotomy Minimally Invasive Pulmonary Embolectomy
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  • Danuel Laan,
  • Edwyn Assaf,
  • John Fallon,
  • Omar Lattouf
Danuel Laan
Emory University
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Edwyn Assaf
American University of Beirut
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John Fallon
Emory University Hospital
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Omar Lattouf
Emory University School of Medicine
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Abstract

Since publication of our initial experience with non-sternotomy minimally invasive pulmonary embolectomy (MIPE) via a left mini thoracotomy, we have expanded our experience, refined the operation and streamlined the post-operative management of patients. Our initial publication described three patients who underwent MIPE.1 We described our technique which included peripheral cardiopulmonary bypass (CPB) via femoral arterial and venous cannulation, left sided 5cm anterior thoracotomy in the 3rd intercostal space, identification and incision of the main pulmonary artery distal to the pulmonic valve, extraction of clot with subsequent primary closure of the pulmonary artery, and use of a 5mm, 30 degree laparoscope as an adjunct to assess clearance of the pulmonary artery.2 The patients included in this series had no post-operative complications, had a mean hospital length of stay of three days with mid-term follow-up up to 8-months revealing no untoward complications of the procedure. With early success of the MIPE at our institution, we began employing it preferentially over sternotomy with central CPB and pulmonary embolectomy. Since initial publication of our results, we have performed the MIPE in two additional patients with excellent outcomes. We herein present augmentations we’ve made to the procedure with a case-presentation which highlights these adaptations.

Peer review status:IN REVISION

15 Jul 2020Submitted to Journal of Cardiac Surgery
16 Jul 2020Assigned to Editor
16 Jul 2020Submission Checks Completed
20 Jul 2020Reviewer(s) Assigned
24 Jul 2020Review(s) Completed, Editorial Evaluation Pending
28 Jul 2020Editorial Decision: Revise Minor