Consider surgery sooner to help save lives

By Cara Murez HealthDay Reporter

WEDNESDAY, Jan. 25, 2023 (HealthDay News) — The American Heart Association has released a new scientific statement on pulmonary embolism (PE), a sometimes fatal disease in which a blood clot travels to the lungs.

The American Heart Association (AHA) statement suggests that surgery should be considered for more people with high-risk PE.

Refined definitions of risk levels can make it easier to identify patients who would benefit from surgery, the AHA said.

The association also called for the development of patient registries to monitor the effectiveness of treatment for intermediate and high risk patients, and better education of doctors and surgeons on surgical intervention options.

“This statement demonstrates that modern surgical management strategies and mechanical circulatory support result in excellent survival (97%) even among the sickest patients, including those who present with cardiac arrest and have undergone CPR,” said Dr Joshua Goldbergwho led the drafting group of the statement.

“Modern surgical strategies and mechanical circulatory support are significantly underutilized,” Goldberg said in an AHA press release. He is a cardiothoracic surgeon at the Westchester Heart and Vascular Center in Valhalla, NY.

Goldberg said the authors of the statement hope it will raise awareness about the safety and effectiveness of modern surgery and mechanical circulatory support for the most unstable patients.

“Furthermore, we hope this statement will facilitate a better understanding of the disease process and effective treatments, and encourage future research to improve survival for patients with this common and fatal disease,” Goldberg said.

Nearly 45% of patients with PE progress to severe symptoms. When this happens, the clot causes high pressure in the lungs and damages the right heart chamber, with a high risk of death.

Even when current treatment guidelines are followed, the risk is around 40% in some groups.

Treatment options for patients include anticoagulant therapy or thrombolysis, breaking up clots with drugs, or a catheter procedure. Other options are advanced surgical procedures and mechanical circulatory support.

The statement suggests considering surgery sooner.

The statement was prepared on behalf of the American Heart Association Council on Cardiovascular Surgery and Anesthesia; the Arteriosclerosis, Thrombosis and Vascular Biology Council; the Council on Lifestyle and Cardiometabolic Health; and the Peripheral Vascular Disease Council.

It was published online January 23 in the AHA Journal, Traffic, and presented simultaneously at a meeting of the Society of Thoracic Surgeons, San Diego.

SOURCE: American Heart Association, press release, January 23, 2023

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