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Pulmonary Thrombectomy
A pulmonary thrombectomy is an emergency surgical procedure used to remove blood clots from the pulmonary arteries. Mechanical thrombectomies can be surgical (surgical thrombectomy) or percutaneous (percutaneous thrombectomy). Surgical thrombectomies were once popular but were abandoned because of poor long-term outcomes. Recently, in selected patients, they have gone through a resurgence with the revision of the surgical technique. Relation to PTE Pulmonary thrombectomies and pulmonary thromboendarterectomies (PTEs) are both operations that remove thrombus. Aside from this similarity they differ in many ways. *PTEs are done on a nonemergency basis while pulmonary thrombectomies are typically done as an emergency procedure. *PTEs typically are done using hypothermia and full cardiac arrest. *PTEs are done for chronic pulmonary embolism, thrombectomies for severe acute pulmonary embolism. *PTEs are generally considered a very effective treatment, surgical thrombectomies are an ...
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Saddle Thromboembolus WArrows
The saddle is a supportive structure for a rider of an animal, fastened to an animal's back by a girth. The most common type is equestrian. However, specialized saddles have been created for oxen, camels and other animals. It is not known precisely when riders first began to use some sort of padding or protection, but a blanket attached by some form of surcingle or girth was probably the first "saddle", followed later by more elaborate padded designs. The solid saddle tree was a later invention, and though early stirrup designs predated the invention of the solid tree, the paired stirrup, which attached to the tree, was the last element of the saddle to reach the basic form that is still used today. Today, modern saddles come in a wide variety of styles, each designed for a specific equestrianism discipline, and require careful fit to both the rider and the horse. Proper saddle care can extend the useful life of a saddle, often for decades. The saddle was a crucial step in ...
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Emergency Procedure
An emergency procedure is a plan of actions to be conducted in a certain order or manner, in response to a specific class of reasonably foreseeable emergency, a situation that poses an immediate risk to health, life, property, or the Natural environment, environment. Where a range of emergencies are reasonably foreseeable, an emergency plan may be drawn up to manage each threat. Most emergencies require urgent intervention to prevent a worsening of the situation, although in some situations, mitigation may not be possible and agencies may only be able to offer palliative care for the aftermath. The emergency plan should allow for these possibilities. Need Organizations are frequently required to have written emergency procedures in place to comply with statutory requirements; demands from their insurers, their regulatory agency, shareholders, stakeholders and unions; to protect staff, the public, the environment, the business, their property and their reputation. Risk assessment ...
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Thoracic Surgery
Cardiothoracic surgery is the field of medicine involved in surgical treatment of organs inside the thoracic cavity — generally treatment of conditions of the heart (heart disease), lungs (lung disease), and other pleural or mediastinal structures. In most countries, cardiothoracic surgery is further subspecialized into cardiac surgery (involving the heart and the great vessels) and thoracic surgery (involving the lungs, esophagus, thymus, etc.); the exceptions are the United States, Australia, New Zealand, the United Kingdom, and some European Union countries such as Portugal. Training A cardiac surgery residency typically comprises anywhere from four to six years (or longer) of training to become a fully qualified surgeon. Cardiac surgery training may be combined with thoracic surgery and / or vascular surgery and called cardiovascular (CV) / cardiothoracic (CT) / cardiovascular thoracic (CVT) surgery. Cardiac surgeons may enter a cardiac surgery residency directly from me ...
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Thrombus
A thrombus (plural thrombi), colloquially called a blood clot, is the final product of the blood coagulation step in hemostasis. There are two components to a thrombus: aggregated platelets and red blood cells that form a plug, and a mesh of cross-linked fibrin protein. The substance making up a thrombus is sometimes called cruor. A thrombus is a healthy response to injury intended to stop and prevent further bleeding, but can be harmful in thrombosis, when a clot obstructs blood flow through healthy blood vessels in the circulatory system. In the microcirculation consisting of the very small and smallest blood vessels the capillaries, tiny thrombi known as microclots can obstruct the flow of blood in the capillaries. This can cause a number of problems particularly affecting the alveoli in the lungs of the respiratory system resulting from reduced oxygen supply. Microclots have been found to be a characteristic feature in severe cases of COVID-19, and in long COVID. Mural th ...
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Pulmonary Artery
A pulmonary artery is an artery in the pulmonary circulation that carries deoxygenated blood from the right side of the heart to the lungs. The largest pulmonary artery is the ''main pulmonary artery'' or ''pulmonary trunk'' from the heart, and the smallest ones are the arterioles, which lead to the capillaries that surround the pulmonary alveoli. Structure The pulmonary arteries are blood vessels that carry systemic venous blood from the right ventricle of the heart to the microcirculation of the lungs. Unlike in other organs where arteries supply oxygenated blood, the blood carried by the pulmonary arteries is deoxygenated, as it is venous blood returning to the heart. The main pulmonary arteries emerge from the right side of the heart, and then split into smaller arteries that progressively divide and become arterioles, eventually narrowing into the capillary microcirculation of the lungs where gas exchange occurs. Pulmonary trunk In order of blood flow, the pulmonary art ...
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Pulmonary Thromboendarterectomy
In thoracic surgery, a pulmonary thromboendarterectomy (PTE), also referred to as pulmonary endarterectomy (PEA), is an operation that removes organized clotted blood (thrombus) from the pulmonary arteries, which supply blood to the lungs. Indication Surgery is indicated in patients with pulmonary artery emboli that are surgically accessible. Thrombi are usually the cause of recurrent/chronic pulmonary emboli and therefore of chronic thromboembolic pulmonary hypertension (CTEPH). PTE is the only definitive treatment option available for CTEPH.Chronic thromboembolic pulmonary hypertension. Fedullo P, Kerr KM, Kim NH, Auger WR Am J Respir Crit Care Med. 2011;183(12):1605. Due to the nature of the procedure, patients with significant hemodynamic or ventilation complications or impairments may be unable to undergo PTE. Description of the surgery A PTE has significant risk; mortality for the operation is typically 5%, but less in centers with high volume and experience. Individuals ...
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Pulmonary Embolism
Pulmonary embolism (PE) is a blockage of an pulmonary artery, artery in the lungs by a substance that has moved from elsewhere in the body through the bloodstream (embolism). Symptoms of a PE may include dyspnea, shortness of breath, chest pain particularly upon breathing in, and coughing up blood. Symptoms of a deep vein thrombosis, blood clot in the leg may also be present, such as a erythema, red, warm, swollen, and painful leg. Signs of a PE include low blood oxygen saturation, oxygen levels, tachypnea, rapid breathing, tachycardia, rapid heart rate, and sometimes a mild fever. Severe cases can lead to Syncope (medicine), passing out, shock (circulatory), abnormally low blood pressure, obstructive shock, and cardiac arrest, sudden death. PE usually results from a blood clot in the leg that travels to the lung. The risk of blood clots is increased by advanced age, cancer, prolonged bed rest and immobilization, smoking, stroke, long-haul travel over 4 hours, certain genetics, g ...
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Heart-lung Machine
Cardiopulmonary bypass (CPB) is a technique in which a machine temporarily takes over the function of the heart and lungs during surgery, maintaining the circulation of blood and oxygen to the body. The CPB pump itself is often referred to as a heart–lung machine or "the pump". Cardiopulmonary bypass pumps are operated by perfusionists. CPB is a form of extracorporeal circulation. Extracorporeal membrane oxygenation is generally used for longer-term treatment. CPB mechanically circulates and oxygenates blood for the body while bypassing the heart and lungs. It uses a heart–lung machine to maintain perfusion to other body organs and tissues while the surgeon works in a bloodless surgical field. The surgeon places a cannula in the right atrium, vena cava, or femoral vein to withdraw blood from the body. Venous blood is removed from the body by the cannula and then filtered, cooled or warmed, and oxygenated before it is returned to the body by a mechanical pump. The cannula used ...
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