title: [Pulmonary thromboendarterectomy as a treatment of chronic pulmonary arterial hypertension secondary to unresolved pulmonary thromboembolism. A preliminary report].
abstract: This is a preliminary report of our initial experience with thromboendarterectomy in the treatment of four patients with chronic major-vessel thromboembolic pulmonary hypertension. Before surgery, these patients all had severe pulmonary hypertension and cor pulmonale as well as significant abnormalities in lung function (mechanics and gas exchange). They were in class III-IV (NYHA). One of our patients died immediately after the procedure as a result of major bleeding. The remaining three surviving patients have shown a remarkable improvement in both, pulmonary hemodynamics and lung function which has been translated in an also significant improvement in their clinical condition. Although there is still a significant risk involved with this procedure, the thromboendarterectomy represents a reasonable and useful therapeutic approach for selected patients with this deadly form of chronic pulmonary hypertension in which other forms of treatment have proved to be unsuccessful.
authors.affiliation: Servicios de Cardioneumología, Instituto Nacional de Cardiología Ignacio Chávez, México, D.F.
authors.forename: R
authors.initials: R
authors.lastname: Barragán
authors.forename: A
authors.initials: A
authors.lastname: Palomar
authors.forename: A
authors.initials: A
authors.lastname: Gómez
authors.forename: M L
authors.initials: ML
authors.lastname: Martínez
authors.forename: J
authors.initials: J
authors.lastname: Salas
authors.forename: G
authors.initials: G
authors.lastname: Cueto
authors.forename: F
authors.initials: F
authors.lastname: Gamboa
authors.forename: A
authors.initials: A
authors.lastname: Portales
authors.forename: J
authors.initials: J
authors.lastname: Molina
authors.forename: J
authors.initials: J
authors.lastname: Sandoval
mesh_terms: D000328:Adult; D002407:Catheterization, Swan-Ganz; D004691:Endarterectomy / Q000379:methods; D005112:Extracorporeal Circulation; D005260:Female; D006439:Hemodynamics; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D011651:Pulmonary Artery / Q000601:surgery*; D011655:Pulmonary Embolism / Q000150:complications / Q000503:physiopathology / Q000601:surgery*
chemical_list: D006493:Heparin
vernacular_title: Tromboendarterectomía pulmonar como tratamiento de la hipertensión arterial pulmonar crónica secundaria a tromboembolia pulmonar no resuelta. Comunicación preliminar.