2023 AHA科学声明：高危肺栓塞的手术管理和机械循环支持：历史背景，现状和未来.pdf

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Circulation

AHASCIENTIFICSTATEMENT

SurgicalManagementandMechanicalCirculatory

SupportinHigh-RiskPulmonaryEmbolisms:

HistoricalContext,CurrentStatus,andFuture

Directions:AScientificStatementFromthe

AmericanHeartAssociation

ThisstatementisendorsedbytheAmericanAssociationforThoracicSurgery.

ThisstatementisendorsedbytheSocietyofThoracicSurgeons.

TheSocietyforCardiovascularAngiographyandInterventionaffirmsthevalueofthisstatement.

JoshuaB.Goldberg,MD,Chair;JayGiri,MD,MPH,FAHA,ViceChair;TaiseiKobayashi,MD;

MarcRuel,MD,MPH,FRCSC,FAHA;AlexanderJ.C.Mittnacht,MD;BelindaRivera-Lebron,MD,MS;

AbeDeAndaJr,MD,FAHA;JohnM.Moriarty,MD;ThomasE.MacGillivray,MD;onbehalfoftheAmericanHeartAssociation

CouncilonCardiovascularSurgeryandAnesthesia;CouncilonArteriosclerosis,ThrombosisandVascularBiology;Councilon

LifestyleandCardiometabolicHealth;andCouncilonPeripheralVascularDisease

ABSTRACT:Acutepulmonaryembolismisthethirdleadingcauseofcardiovasculardeath,withmostpulmonaryembolism–related

mortalityassociatedwithacuterightventricularfailure.Althoughtherehasrecentlybeenincreasedclinicalattentiontoacute

pulmonaryembolismwiththeadoptionofmultidisciplinarypulmonaryembolismresponseteams,mortalityofpatientswithpulmonary

embolismwhopresentwithhemodynamiccompromiseremainshighwhencurrentguideline-directedtherapyisfollowed.Because

historicaldataandpracticepatternsaffectcurrentconsensustreatmentrecommendations,surgicalembolectomyhaslargelybeen

relegatedtopatientswhohavecontraindicationstoothertreatmentsorwhenothertreatmentmodalitiesfail.Despiteaselection

biastowardpatientswithgreaterillness,agrowingbodyofliteraturedescribesthesafetyandefficacyofthesurgicalmanagement

ofacutepulmonaryembolism,especiallyinthehemodynamicallycompromisedpopu

无所谓。

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