Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti
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Acute massive pulmonary embolism remains potentially lethal with mortality varying between 2553%. In the thrombolytic era, surgical pulmonary embolectomy is deemed as a rescue approach for patients with absolute contraindication of thrombolysis or its failure. However, close interdisciplinary cooperation, meticulous choice of optimal reperfusion strategy, standardization of surgical approach, and mainly the inclusion of mechanical circulatory support into the treatment algorithm have led to a drop in in-hospital mortality below 10% in the last 10 years. ⋯ Subsequently, optimal reperfusion strategy can be chosen or patients may be transported for it. The review highlights the contemporary role of surgical pulmonary embolectomy and extracorporeal membrane oxygen therapy in the treatment algorithm for acute massive pulmonary embolism, summarising current perspectives on the indications and contraindications for these treatment strategies and their results. Key words: massive pulmonary embolism - surgical pulmonary embolectomy - extracorporeal membrane oxygen therapy.
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Recurrent pectus excavatum is the most serious late complication after primary repair. Redo open repair (Highly Modified Ravitch Repair, HMRR) or minimally invasive repair of pectus excavatum (MIRPE) are usually performed in indicated cases. This paper focuses on the evaluation of available redo surgical techniques in adult and adolescent patients with recurrent pectus excavatum. ⋯ Despite our limited experience with both techniques in the treatment of recurrent pectus excavatum we believe that MIRPE should be regarded as a safe and effective technique for the redo repair in adolescent and adult patients.Key words: HMRR - MIRPE recurrent pectus excavatum.