title: Preoperative transcatheter occlusion of bronchopulmonary collateral artery reduces reperfusion pulmonary edema and improves early hemodynamic function after pulmonary thromboendarterectomy.
abstract: OBJECTIVE
  The present study assessed the effectiveness of preoperative transcatheter occlusion of the bronchopulmonary collateral artery (PTOBPCA) in reducing reperfusion pulmonary edema after pulmonary thromboendarterectomy (PEA).
  
  
  METHODS
  The data from 155 patients with chronic thromboembolic pulmonary hypertension at Anzhen Hospital, treated from January 2007 to August 2013, with PEA were retrospectively reviewed. The patients were classified into a control (group A, n = 87) and treated (group B, underwent PTOBPCA, n = 68) group. The reperfusion pulmonary edema incidence, mechanical ventilation and intensive care unit hospitalization duration, and hemodynamic function were compared between the 2 groups.
  
  
  RESULTS
  Of the 87 patients in group A, 5 died in-hospital (5.7% mortality); no patient in group B died (0% mortality; P = .035). In group A, 9 patients (10.3%) required extracorporeal membrane oxygenation (ECMO) after PEA; 1 patient (1.5%) in group B required ECMO (chi-square test, P = .026, χ(2) = 4.980). Group B had shorter intubation and intensive care unit hospitalization times, lower mean pulmonary artery pressures and pulmonary vascular resistance, higher partial pressures of oxygen in arterial blood and oxygen saturation, and decreased medical expenditure compared with group A. During a mean 37.1 ± 21.4 months of follow-up, 3 patients in group A and 2 in group B died; however, the difference in the actuarial survival at 3 years postoperatively between the 2 groups was not statistically significant.
  
  
  CONCLUSIONS
  PTOBPCA can reduce the incidence of reperfusion pulmonary edema, shorten intensive care unit hospitalization and intubation duration, improve early hemodynamic function, and reduce ECMO usage after PEA.
authors.affiliation: Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, and Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China. Electronic address: ganhuili@126.com.
authors.forename: Hui-Li
authors.initials: HL
authors.lastname: Gan
authors.affiliation: Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, and Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China.
authors.forename: Jian-Qun
authors.initials: JQ
authors.lastname: Zhang
authors.affiliation: Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, and Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China.
authors.forename: Jian-Chao
authors.initials: JC
authors.lastname: Sun
authors.affiliation: Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, and Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Feng
authors.affiliation: Department of Image Diagnosing, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China.
authors.forename: Xiao-Yong
authors.initials: XY
authors.lastname: Huang
authors.affiliation: Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, and Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China.
authors.forename: Jia-Kai
authors.initials: JK
authors.lastname: Lu
authors.affiliation: Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, and Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China.
authors.forename: Xiu-Hua
authors.initials: XH
authors.lastname: Dong
mesh_terms: D000328:Adult; D060666:Airway Extubation; D021721:Balloon Occlusion / Q000009:adverse effects / Q000401:mortality; D016009:Chi-Square Distribution; D002681:China / Q000453:epidemiology; D002908:Chronic Disease; D003097:Collateral Circulation; D003131:Combined Modality Therapy; D004691:Endarterectomy / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006439:Hemodynamics; D017052:Hospital Mortality; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D015994:Incidence; D007362:Intensive Care Units; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008168:Lung / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011652:Pulmonary Circulation; D011654:Pulmonary Edema / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000517:prevention & control*; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome