[Chronic thromboembolic pulmonary hypertension and its treatment with pulmonary thrombendarterectomy].
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.
Klepetko
W
W
Abteilung Herz-Thoraxchirurgie, Universitätsklinik für Chirurgie, Wien.
Moritz
A
A
Burghuber
O C
OC
Ziesche
R
R
Kneussl
M
M
Lang
I
I
Mares
P
P
Hiesmayer
M
M
Kontrus
M
M
Herold
C
C
D000328:Adult; D002302:Cardiac Output / Q000502:physiology; D004541:Eisenmenger Complex / Q000000981:diagnostic imaging / Q000503:physiopathology; D004691:Endarterectomy; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011669:Pulmonary Wedge Pressure / Q000502:physiology; D015427:Reperfusion Injury / Q000000981:diagnostic imaging / Q000503:physiopathology; D017131:Thrombectomy; D014057:Tomography, X-Ray Computed; D014655:Vascular Resistance / Q000502:physiology
Die chronisch-thromboembolische pulmonale Hypertension und ihre Behandlung mit der pulmonalen Thrombendarteriektomie.