Association Between Reperfusion Therapy and Outcomes in Patients with Acute Pulmonary Embolism and Right Heart Thrombi.

Right heart thrombi (RHT) may be detected in <4% of patients with pulmonary embolism (PE) [1], and are associated with worse outcomes [1–4]. Given the limited existing evidence, society guidelines or consensus statements have either not addressed the management of RHT, or have based their recommendations on prior case reports, case series, or pooled results of case series [5–8]. It is plausible that reperfusion strategies reduce the adverse outcomes in PE patients with RHT; thrombolysis may dissolve the RHT and emboli, while thrombectomy might reduce the thromboembolic burden. Using the data from RIETE (Registro Informatizado Enfermedad TromboEmbolica), a prospective international venous thromboembolism registry, we sought to compare the outcomes of patients with PE and coexisting RHT, with versus without reperfusion therapy. Footnotes This manuscript has recently been accepted for publication in the European Respiratory Journal . It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article. Conflict of interest: Dr. Bikdeli reports and Dr. Bikdeli reports that he is a consulting expert, on behalf of the plaintiff, for litigation related to a specific type of IVC filters. Conflict of interest: Dr. Jimenez has nothing to disclose. Conflict of interest: Dr. Barrios has nothing to disclose. Conflict of interest: Dr. Ballaz has nothing to disclose. Conflict of interest: Dr. Verhamme reports honoraria for lectures and consultancy from Bayer, Boehringer-Ingelheim, Daiichi-Sankyo, Pfizer, BMS, and Portola. Conflict of interest: Dr. Monreal has nothing to disclose. Conflict of interest: Dr. Muriel has nothing to disclose.