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Abstract

The pulmonary embolism is a pathology that endangers life and it requires an immediate treatment. In order to get the best results there should be a high degree of clinical suspicion that allows us to make an early diagnosis. It requires a pharmacological treatment with anticoagulation but in certain cases there is necessary a surgical treatment. The objective of this case report is to describe the current indications for the surgical pulmonary embolectomy in a patient with pulmonary embolism. Case Presentation: This is the presentation of a case in a patient with pulmonary embolism, haemodynamic instability and a horse saddle thrombus located in a patent foramen ovale which was expanded on the both heart atriums. This patient was treated with surgical pulmonary embolectomy. Following the surgical pulmonary embolectomy the patient had a recurrent pulmonary embolism episode that was treated with the insertion of a percutaneous vena cava filter and a newly surgical pulmonary embolectomy. The patient had a satisfactory postoperative evolution with an early discontinuation of the ventilatory and haemodynamic support. Conclusion: The surgical pulmonary embolectomy is still an applicable treatment for the pulmonary embolism in patients with haemodynamic instability, absolute contraindication to systemic thrombolytic therapy or failure to this therapy, patent foramen ovale and an intracardiac floating thrombus. MED.UIS. 2017;30(1):93-7.Keywords: Pulmonary embolism. Embolectomy. Foramen oval, Patent. Venous thrombosis.