PMID- 34157383 OWN - NLM STAT- MEDLINE DCOM- 20220818 LR - 20220829 IS - 1532-9488 (Electronic) IS - 1043-0679 (Linking) VI - 34 IP - 3 DP - 2022 Autumn TI - Comparison of Surgical Embolectomy and Veno-arterial Extracorporeal Membrane Oxygenation for Massive Pulmonary Embolism. PG - 934-942 LID - S1043-0679(21)00292-6 [pii] LID - 10.1053/j.semtcvs.2021.06.011 [doi] AB - Massive pulmonary embolism (MPE) is associated with a 20-50% mortality rate with guideline directed therapy. MPE treatment with surgical embolectomy (SE) or venoarterial extracorporeal membrane oxygenation (VA-ECMO) have shown promising results. In the context of a surgical management strategy for MPE, a comparison of outcomes associated with VA-ECMO or SE was performed. A retrospective review of a single institution cardiac surgery database was performed, identifying MPE treated with SE or VA-ECMO between 2005-2020. Primary outcome was in-hospital survival. 59 MPE [27 (46.8%) VA-ECMO vs 32 (54.2%) SE] were identified. All presented with elevated cardiac biomarkers, tachycardia (mean heart rate 113 +/- 20 beats/minute), hypotension (mean systolic blood pressure 85 +/- 22 mm Hg) and vasopressors requirement, without significant differences between cohorts. Preoperative CPR was performed in 37.3% (22/59), without a significant difference between cohorts. More VA-ECMO presented with questionable neurologic status (GCS