title: Clinical outcomes of thromboendarterectomy for chronic thromboembolic pulmonary hypertension: 12-year experience.
abstract: BACKGROUND
  We present our 12-year experience of pulmonary thromboendarterectomy in patients with chronic thromboembolic pulmonary hypertension.
  
  
  METHODS
  Between January 1999 and March 2011, 16 patients underwent pulmonary thromboendarterectomy. Eleven patients (69%) were classified as functional class III or IV based on the New York Heart Association (NYHA) classification. Seven patients had a history of inferior vena cava filter insertion, and 5 patients showed coagulation disorders. Pulmonary thromboendarterectomy was performed during total circulatory arrest with deep hypothermia in 14 patients.
  
  
  RESULTS
  In-hospital mortality and late death occurred in 2 patients (12.5%) and 1 patient (6.3%), respectively. Extracorporeal membrane oxygenation support was required in 4 patients who developed severe hypoxemia after surgery. Thirteen of the 14 survivors have been followed up for 54 months (range, 2 to 141 months). The pulmonary arterial systolic pressure and cardiothoracic ratio on chest radiography was significantly decreased after surgery (76±26 mmHg vs. 41±17 mmHg, p=0.001; 55%±8% vs. 48%±3%, p=0.003). Tricuspid regurgitation was reduced from 2.1±1.1 to 0.7±0.6 (p=0.007), and the NYHA functional class was also improved to I or II in 13 patients (81%). These symptomatic and hemodynamic improvements maintained during the late follow-up period.
  
  
  CONCLUSIONS
  Pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension shows good clinical outcomes with acceptable early and long term mortality.
authors: Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Korea.
authors: Se Jin
authors: SJ
authors: Oh
authors: Jin San
authors: JS
authors: Bok
authors: Ho Young
authors: HY
authors: Hwang
authors: Kyung-Hwan
authors: KH
authors: Kim
authors: Ki Bong
authors: KB
authors: Kim
authors: Hyuk
authors: H
authors: Ahn
keywords: Endarterectomy; Pulmonary arteries; Thromboembolism; Tricuspid valve