The efficacy of pulmonary thromboendarterectomy on long-term gas exchange.
It has not been delineated in detail how pulmonary thromboendarterectomy (PTE) affects gas exchange through long-term follow-up. In Japan, this surgery has been undertaken in a limited number of institutions, and the results of PTE have not been well publicized. A total of 25 patients were operated on during the period from 1985 to 1996 at our institution, and the overall mortality rate was 16%. Our criteria for PTE were based on the following: 1) thrombi surgically accessible as judged by angiographic study; 2) mean pulmonary arterial pressure > or = 30 mmHg. The efficacies of PTE were analysed on haemodynamics as well as gas exchange at one month postsurgery and during follow-up (6-24 months). Significant haemodynamic improvement was obtained as early as 1 month after surgery. Improvement of gas exchange lagged, but was then observed during follow-up, and the improvement level of pulmonary haemodynamics was sustained. The early postoperative restrictive impairment and ventilation-perfusion abnormality on lung perfusion scan resolved during the follow-up period. It was concluded that the early postoperative efficacy of pulmonary throm-boendarterectomy was mainly achieved due to the reduction of pulmonary hypertension, whereas improvement in gas exchange was obtained over the longer term.
Tanabe
N
N
Dept of Chest Medicine, Chiba University School of Medicine, Japan.
Okada
O
O
Nakagawa
Y
Y
Masuda
M
M
Kato
K
K
Nakajima
N
N
Kuriyama
T
T
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004691:Endarterectomy; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000601:surgery*; D011652:Pulmonary Circulation; D011655:Pulmonary Embolism / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D011659:Pulmonary Gas Exchange; D015656:Respiratory Mechanics; D012189:Retrospective Studies; D016896:Treatment Outcome