title: [Chronic thromboembolic pulmonary hypertension and its treatment with pulmonary thrombendarterectomy].
abstract: 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.
authors.affiliation: Abteilung Herz-Thoraxchirurgie, Universitätsklinik für Chirurgie, Wien.
authors.forename: W
authors.initials: W
authors.lastname: Klepetko
authors.forename: A
authors.initials: A
authors.lastname: Moritz
authors.forename: O C
authors.initials: OC
authors.lastname: Burghuber
authors.forename: R
authors.initials: R
authors.lastname: Ziesche
authors.forename: M
authors.initials: M
authors.lastname: Kneussl
authors.forename: I
authors.initials: I
authors.lastname: Lang
authors.forename: P
authors.initials: P
authors.lastname: Mares
authors.forename: M
authors.initials: M
authors.lastname: Hiesmayer
authors.forename: M
authors.initials: M
authors.lastname: Kontrus
authors.forename: C
authors.initials: C
authors.lastname: Herold
mesh_terms: 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
vernacular_title: Die chronisch-thromboembolische pulmonale Hypertension und ihre Behandlung mit der pulmonalen Thrombendarteriektomie.