The History of Pulmonary Embolectomy Before the Advent of CPB

  • Marco Vola
  • Jean-Francois Fuzellier


The history of the surgical approach to pulmonary embolism before the advent of CPB was exclusively limited to acute forms and very much associated with the person of Friederich Trendelenburg. He observed that the time between the onset of the embolism and ensuing death allowed time for acute surgical treatment. He developed in animal studies (1907) a surgical procedure for pulmonary embolectomy, later known as the Trendelenburg operation. Only after his death, his pupil, Martin Kirschner successfully removed clots from the arterial pulmonary artery of a 38-year-old woman. Sporadic reports of the procedure were issued until the advent of cardiopulmonary bypass, which increased the opportunities for disseminating the practice of surgical embolectomy. Chronic constrictive pericarditis had been anatomically described by Galen (AD 160), but the surgical usefulness of liberating the ventricles was suggested by Weill in 1895. A surgical technique of pericardial decortication was presented by Delorme in 1898, and was performed by Rehn in 1913 on a human being. Current surgical decortications follow the same principles, but are practiced after an accurate topographic evaluation of the pericardium.


Pulmonary Artery Pulmonary Embolism Cardiopulmonary Bypass Constrictive Pericarditis Pectoralis Major Muscle 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Trendelenburg F (1908) Über die Operative Behandlung der Embolie der Lungenarterie. Arch Klin Chir 86:686–700Google Scholar
  2. 2.
    Bernstein AM, Koo HP, Bloom DA (1999) Beyond the Trendelenburg position: Friedrich Trendelenburg’s life and surgical contributions. Surgery 126(1):78–82PubMedCrossRefGoogle Scholar
  3. 3.
    Cooley DA, Beall AC Jr, Alexander JK (1961) Acute massive pulmonary embolism. Successful surgical treatment using temporary cardiopulmonary bypass. JAMA 5(177):283–286CrossRefGoogle Scholar
  4. 4.
    Lancisi GM (1728) De Motu Cordis et Aneurysmatibus. Salvioni, Rome, pp 38–39Google Scholar
  5. 5.
    Pick F (1896) Über chronische unter dem Bilde dem Lebercirrhose verlaufende Perikarditis (perikardische Pseudolebecirrhose) nebst Bermerkungen über die Zuckergussleber (Curschmann). Z Klin Med 29:385Google Scholar
  6. 6.
    Holman E (1951) The surgical treatment of constrictive pericarditis: clinical and experimental observations. Ann R Coll Surg Engl 9(5):309–317PubMedCentralPubMedGoogle Scholar
  7. 7.
    Weill E (1895) Traité clinique des maladies du coeur chez les enfants. Doin, Paris, p 128Google Scholar
  8. 8.
    Delorme E (1898) Sur un traitement chirurgical de la Symphyse cardo-pericardique. Bull Mem Soc Chir Paris 24:918Google Scholar
  9. 9.
    Brauer L (1903) Die Kardiolyse und ihre Indikationen. Arch Klin Chir 71:258Google Scholar
  10. 10.
    Rehn L (1913) Die Chirurgie des Herzens und des Herzbeutels. Berliner Klin Wchnschr, 50:241–246Google Scholar
  11. 11.
    Meyer JA (1988) Claude Beck and cardiac resuscitation. Ann Thorac Surg 45(1):103–105PubMedCrossRefGoogle Scholar
  12. 12.
    Beck CS (1929) The effect of surgical solution of chlorinated soda (Dakin’s solution) in the pericardial cavity. Arch Surg 18(4):1659–1671CrossRefGoogle Scholar
  13. 13.
    Meyer JA (1990) Friedrich Trendelenburg and the surgical approach to massive pulmonary embolism. Arch Surg 125(9):1202–1205PubMedCrossRefGoogle Scholar
  14. 14.
    Griswold RA (1993) The Trendelenburg operation for pulmonary embolism. Ann Surg 98(1):33–42CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2013

Authors and Affiliations

  1. 1.Service de Chirurgie CardiovasculaireCentre Hospitalier UniversitaireSt-Priest en JarezFrance

Personalised recommendations