Most Read Articles
Elvira Manzano, 28 Jul 2020
The efficacy and cardiovascular (CV) safety of the SGLT2* inhibitor empagliflozin vs DPP-4** inhibitors and GLP-1*** receptor agonists in real-world patients were demonstrated in two interim analyses of the EMPRISE+ study presented at ADA 2020.
Roshini Claire Anthony, 4 days ago

Patients hospitalized with mild-to-moderate COVID-19 who are on angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) for hypertension should continue these medications, according to primary results of the BRACE CORONA trial presented at ESC 2020.

Tristan Manalac, 09 Jul 2020
Left ventricular assist devices (LVADs) trigger almost immediate favourable metabolic changes in both diabetics and nondiabetics, according to a recent study.
Tristan Manalac, 04 Sep 2020
Anticoagulation therapy may be of value to patients with new-onset atrial fibrillation (AF) associated with sepsis, easing the risk of all-cause mortality and ischaemic stroke without increasing the likelihood of major bleeding, reports a study presented at the Digital 2020 Congress of the European Society of Cardiology (ESC).

Surgical management safe, effective at achieving RV recovery in acute pulmonary embolism

30 Aug 2020

Patients with high-risk submassive (SMPE) and massive pulmonary embolism (MPE) achieve right ventricular (RV) recovery following surgical management, a study has found.

The authors compared surgical embolectomy and venoarterial extracorporeal membrane oxygenation (ECMO) for MPE vs high-risk SMPE between 2005 and 2019. Improvements in central venous pressure, pulmonary artery systolic pressure, RV/left ventricular (LV) ratio, and RV fractional area change characterized RV recovery.

Overall, 136 patients with PE (92 with SMPE and 44 with MPE) were included in the analysis. Those with MPE were more likely to present with syncope (59.1 percent vs 25.0 percent; p=0.0003), with Glasgow Coma Scale score ≤4 (22.7 percent vs 0 percent), and with failed thrombolysis (18.2 percent vs 4.3 percent; p=0.008).

Embolectomy was most often used for SMPE patients (98.9 percent), while ECMO was used more for those with MPE (ECMO in 40.9 percent; embolectomy in 59.1 percent).

RV function improved as measured by the following: central venous pressure (from 23.4±4.9 to 10.5±3.1 mm Hg), pulmonary artery systolic pressure (from 60.6±14.2 to 33.8±10.7 mm Hg), RV/LV ratio (from 1.19±0.33 to 0.87±0.23; p<0.005), and fractional area change (from 26.8 to 41.0; p<0.005). Mortality was relatively low at 4.4 percent (six of 136; one of 92 [1.1 percent] SMPE patients; five of 44 [11.6 percent] MPE patients).

In subgroup analysis, morbidity and mortality showed a robust correlation with preoperative cardiopulmonary resuscitation.

“Acute PE is associated with high morbidity and mortality because of RV failure,” the authors said. “There is evidence suggesting surgical therapy (surgical embolectomy or venoarterial ECMO) is safe and effective.”

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Cardiology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Elvira Manzano, 28 Jul 2020
The efficacy and cardiovascular (CV) safety of the SGLT2* inhibitor empagliflozin vs DPP-4** inhibitors and GLP-1*** receptor agonists in real-world patients were demonstrated in two interim analyses of the EMPRISE+ study presented at ADA 2020.
Roshini Claire Anthony, 4 days ago

Patients hospitalized with mild-to-moderate COVID-19 who are on angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) for hypertension should continue these medications, according to primary results of the BRACE CORONA trial presented at ESC 2020.

Tristan Manalac, 09 Jul 2020
Left ventricular assist devices (LVADs) trigger almost immediate favourable metabolic changes in both diabetics and nondiabetics, according to a recent study.
Tristan Manalac, 04 Sep 2020
Anticoagulation therapy may be of value to patients with new-onset atrial fibrillation (AF) associated with sepsis, easing the risk of all-cause mortality and ischaemic stroke without increasing the likelihood of major bleeding, reports a study presented at the Digital 2020 Congress of the European Society of Cardiology (ESC).