Chronic thromboembolic pulmonary hypertension and its treatment with pulmonary thrombendarterectomy
Klepetko, W.; Moritz, A.; Burghuber, O.C.; Ziesche, R.; Kneussl, M.; Lang, I.; Mares, P.; Hiesmayer, M.; Kontrus, M.; Herold, C.
Wiener Klinische Wochenschrift 107(13): 396-402
1995
ISSN/ISBN: 0043-5325 PMID: 7638970 Document Number: 453713
Chronic recurrent pulmonary embolism can lead to extensive pulmonary hypertension by obstruction of the pulmonary vessels. Pulmonary thrombendarteriectomy is a new approach to normalizing the elevated pulmonary vascular resistance by removal of the adsorbed thrombi. Between 1992 and 1994 we have operated on 8 patients aged between 34 and 62 years. The first patient died due to extensive reperfusion edema, all others showed significant improvement in hemodynamic parameters (mean pulmonary artery pressure preop. 63 +/- 5 mmHg; postop. 30 +/- 9 mmHg; Cardiac Index preop. 2.0 +/- 0.2 l/min; postop. 3.5 +/- 0.5 l/min; pulmonary vascular resistance preop. 1169 +/- 75 dyn; postop. 228 +/- 55 dyn) and exercise performance (NYHA classification preop. III-IV, postop. I-II). Pulmonary thrombendarteriectomy represents an efficient method to normalize elevated pulmonary pressure and exercise performance of patients with far-advanced chronic thromboembolic pulmonary hypertension.