Thromboendarterectomy for chronic pulmonary thromboembolism.
OBJECTIVE
To evaluate the improving reliability and safety of thromboendarterectomy and perioperative management for chronic pulmonary thromboembolism.


METHODS
The clinical data of 12 cases with chronic pulmonary thromboembolism, who underwent thromboendarterectomy assisted by low flow or circulation arrest with deep hypothermia, were reviewed retrospectively.


RESULTS
Pulmonary artery pressure decreased 20 to 40 mmHg immediately after surgical procedures in 9 cases. The postoperative pulmonary edema at various degrees happened in 12 cases, among them, 1 died of severe lung infection and pulmonary re-embolism at 19 days postoperation. Computed tomography pulmonary angiography and angiography of 11 cases indicated that the original obstruction of pulmonary artery disappeared. During the follow-up period of 2 months to 5 years, the clinical symptoms and activity was improved.


CONCLUSIONS
Thromboendarterectomy is an effective treatment for chronic pulmonary thromboembolism. The outcome of the surgical procedure needs to be further investigated and followed up regularly according to an evaluative system, because it might be influenced by multiple factors.
Ren
Hua
H
Department of Cardiovascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730. renjohnh@yahoo.com.cn
Su
Pi-Xiong
PX
Zhang
Chao-Ji
CJ
Gu
Song
S
Zhang
Heng
H
Wang
Chen
C
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002908:Chronic Disease; D004487:Edema / Q000209:etiology; D004691:Endarterectomy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000601:surgery*; D012189:Retrospective Studies