title: Pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension.
abstract: BACKGROUND
  Pulmonary thromboendarterectomy (PTE) is a surgical procedure which is considered the only effective and potentially curative treatment for chronic thromboembolic pulmonary hypertension (CTEPH). CTEPH is a rare outcome from pulmonary emboli and, when left untreated, will result in right ventricular failure and death.
  
  
  METHODS
  From June 1999 to November 2003, 40 of these procedures were performed in our institution. Emphasis is placed on multidisciplinarity and cooperation between different medical and surgical disciplines. Perfusion management consists of myocardial and cerebral protection, deep hypothermia with multiple periods of circulatory arrest, reperfusion at hypothermia, hemofiltration and cellsaving techniques.
  
  
  RESULTS
  Hemodynamic improvement occurs immediately post operation. Mean pulmonary artery pressure decreased from 50 +/- 11 to 38 +/- 10 mmHg, pulmonary vascular resistance from 1246+482 to 515 +/- 294 dynes s/cm5 and cardiac index increased from 1.54 +/- 0.54 to 2.63 +/- 0.75 L/min per m2. Pump runs had an average duration of 187 +/- 29 min, circulatory arrest time was 29 +/- 11 min and crossclamp time 36 +/- 14 min. Extracorporeal membrane oxygenation can be an ultimate treatment for specific postoperative problems like persistent pulmonary hypertension and/or reperfusion pulmonary edema.
authors.affiliation: Department of Extra Corporeal Circulation, UZ Gasthuisberg, KU Leuven, Belgium. luc.puis@uz.kuleuven.ac.be
authors.forename: Luc
authors.initials: L
authors.lastname: Puis
authors.forename: Eddy
authors.initials: E
authors.lastname: Vandezande
authors.forename: Leen
authors.initials: L
authors.lastname: Vercaemst
authors.forename: Patrick
authors.initials: P
authors.lastname: Janssens
authors.forename: Yvan
authors.initials: Y
authors.lastname: Taverniers
authors.forename: Mark
authors.initials: M
authors.lastname: Foulon
authors.forename: Roland
authors.initials: R
authors.lastname: Demeyere
authors.forename: Marion
authors.initials: M
authors.lastname: Delcroix
authors.forename: Willem
authors.initials: W
authors.lastname: Daenen
mesh_terms: D002908:Chronic Disease; D004691:Endarterectomy; D005112:Extracorporeal Circulation / Q000379:methods; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D011654:Pulmonary Edema / Q000209:etiology / Q000517:prevention & control*; D011655:Pulmonary Embolism / Q000150:complications / Q000601:surgery*; D012189:Retrospective Studies