title: Pulmonary endarterectomy: with use of moderate hypothermia and antegrade cerebral perfusion without circulatory arrest.
abstract: Pulmonary endarterectomy is the treatment of choice in suitable patients who have chronic thromboembolic pulmonary hypertension. The most common surgical technique involves the use of deep hypothermic circulatory arrest. Herein, we describe a modified aortic clamping technique with selective antegrade cerebral perfusion, performed with moderate hypothermia but without circulatory arrest. This technique avoids the adverse effects of deep hypothermic circulatory arrest and also establishes a bloodless surgical field. We achieved good surgical results and acceptable long-term outcomes in 3 patients with use of this technique, which we recommend as a feasible alternative to the standard operative practice.
authors.affiliation: Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Hospital, 06100 Ankara, Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Lafci
authors.forename: Irfan
authors.initials: I
authors.lastname: Tasoglu
authors.forename: Mahmut Mustafa
authors.initials: MM
authors.lastname: Ulas
authors.forename: Adnan
authors.initials: A
authors.lastname: Yalcinkaya
authors.forename: Kerim
authors.initials: K
authors.lastname: Cagli
mesh_terms: D000328:Adult; D001011:Aorta / Q000503:physiopathology / Q000601:surgery*; D002560:Cerebrovascular Circulation; D003250:Constriction; D004691:Endarterectomy; D065627:Familial Primary Pulmonary Hypertension; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000503:physiopathology / Q000601:surgery*; D007036:Hypothermia, Induced; D008875:Middle Aged; D010477:Perfusion / Q000379:methods*; D011651:Pulmonary Artery / Q000503:physiopathology / Q000601:surgery*; D011652:Pulmonary Circulation; D016896:Treatment Outcome