Possibilities and Perspectives of Retrograde Pulmonary Artery Perfusion as a Component of Surgical Treatment of Pulmonary Embolism

Aim of the study: to analyze the results of performing retrograde perfusion of the pulmonary artery during an open thromboembolectomy from the pulmonary artery. Materials and methods: the experience of performing retrograde perfusion of the pulmonary artery in 10 patients operated in our clinic for massive pulmonary embolism is presented. Retrograde perfusion was performed after the stage of embolectomy from the pulmonary artery. For the latter, we used a disposable cardioplegic solution delivery system and 2 cardioplegic pumps of the heart-lung machine: the first for taking blood perfusate from the oxygenator, the second for supplying the combined solution. The blood perfusate and solution were mixed in a 3:1 ratio and injected selectively into the orifices of the pulmonary veins under a pressure of up to 20 mm Hg. (volume perfusion rate 200-250 ml/min) for 4 minutes. Results: despite the initial severity of the patients' condition, as well as the amount of surgical intervention performed, the hospital survival rate was 100%. Along with this, we did not note the development of specific complications, as well as the aggravation of the course of the intraoperative and early postoperative periods. Conclusion: retrograde pulmonary artery perfusion is a very encouraging and promising technique that provides effective and safe removal of small thromboembolism from the peripheral parts of the pulmonary arterial bed, as well as preventing the development of residual pulmonary hypertension as a result of developing intraoperative air embolism.