[Pulmonary thrombendarteriectomy].
BACKGROUND
Chronic thromboembolic pulmonary hypertension is a late sequela following acute pulmonary embolism. Incomplete resolution of thrombotic material results in persistent obstruction of the pulmonary arterial bed, which can be treated by pulmonary thrombendarterectomy.


RESULTS
This desobliteration of the pulmonary arteries is performed under conditions of deep hypothermia and circulatory arrest. Currently, perioperative mortality ranges between 10 and 15% and is mainly limited by persistent diffuse pulmonary artery disease independent of central obstruction. Postoperatively, pulmonary vascular resistance is normalized. Exercise tolerance of the patients is likewise improved.


CONCLUSIONS
Thus, pulmonary thrombendarterectomy is an effective treatment for chronic thromboembolic pulmonary hypertension with results superior to those of lung transplantation.
Demertzis
S
S
Abt. für Thorax-, Herz- und Gefässchirurgie, Universitätskliniken des Saarlandes, Homburg.
Schäfers
H J
HJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000792:Angiography; D002908:Chronic Disease; D017128:Embolectomy / Q000379:methods*; D004691:Endarterectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006324:Heart Arrest, Induced; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult