[Surgery in chronic pulmonary embolism].
BACKGROUND
Chronic lung thromboembolism may develop after episodes of acute lung emboli. Instead of being resoluted, the thromboembolic material is incorporated into the walls of the lung arteries causing obstruction of the blood flow. Secondarily, pulmonary hypertension develops and patients experience increasing dyspnoea on exertion. In chronic pulmonary thromboembolism, drug therapy is of little benefit. Surgical thromboendarterectomy of lung arteries has emerged as an effective treatment for these very sick patients.


METHODS
This paper discusses our experience with seven patients who underwent pulmonary thromboendarterectomy during the five-year period 1995-99 at our institution. The preoperative and postoperative haemodynamic evaluation of all patients were similar.


RESULTS
For five patients the working capacity was significantly improved, one had limited symptomatic effect, and one died perioperatively due to massive surgical bleeding.


CONCLUSIONS
Pulmonary thromboendarterectomy may be indicated in selected patients with severe dyspnoea due to pulmonary hypertension secondary to chronic pulmonary thromboembolism.
Thoraxkirurgisk avdeling Hjerte- og lungeklinikken Rikshospitalet 0027 Oslo.
S T
ST
Baksaas
O R
OR
Geiran
S
S
Iversen
D000328:Adult; D002908:Chronic Disease; D004691:Endarterectomy; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011651:Pulmonary Artery / Q000473:pathology; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome