A novel technique for pulmonary endarterectomy in the presence of patent coronary artery bypass grafts.
Pulmonary endarterectomy (PEA) is the definitive surgical treatment for chronic thromboembolic pulmonary hypertension, with excellent short- and long-term results. PEA following previous coronary artery bypass graft surgery carries a risk of damage to patent grafts, as well as the risk of inadequate myocardial protection, especially when a patent pedicled internal thoracic artery graft is present. We report a technique where PEA may be safely and successfully accomplished ensuring, adequate clearance of bilateral pulmonary thromboembolic disease via a right pulmonary arteriotomy, avoiding the patent bypass grafts overlying the pulmonary trunk, while ensuring adequate myocardial protection.
Department of Cardiothoracic Surgery,  Papworth Hospital, Cambridge,  UK.
Balakrishnan
B
Mahesh
Nnamdi
N
Nwaejike
John J
JJ
Dunning
David P
DP
Jenkins
D002908:Chronic Disease; D001026:Coronary Artery Bypass; D004691:Endarterectomy / Q000379:methods*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D011655:Pulmonary Embolism / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome