title: Surgical outcome of two difficult cases with predominant proximal pulmonary artery lesions of chronic thromboembolic pulmonary hypertension.
abstract: Pulmonary endarterectomy (PEA) for chronic thromboembolic pulmonary hypertension (CTEPH) is still challenging. The outcome of patients with proximal pulmonary artery disease is generally better than that of a distal lesion. However, we experienced poor results in two difficult cases having predominant proximal lesions even after effective PEA. Both of them had a long-time history of CTEPH and preoperative condition was critical. Although relatively large amount of thickened intima with massive thrombi were extracted from the proximal pulmonary arteries, they required postoperative percutaneous cardiopulmonary support due to residual pulmonary hypertension. Both of them finally died from pulmonary bleeding and adult respiratory distress syndrome.
authors.affiliation: Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Surgery, Suita, Osaka, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Murashita
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ogino
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Matsuda
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Sasaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tanaka
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Iba
authors.forename: Keitaro
authors.initials: K
authors.lastname: Doumae
authors.forename: Tatsuki
authors.initials: T
authors.lastname: Fujiwara
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Shimada
authors.forename: Naoki
authors.initials: N
authors.lastname: Okuda
keywords: chronic thromboembolic pulmonary hypertension; distal lesion; proximal lesion; pulmonary endarterectomy
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