title: [5-year surgical results in patients with chronic postembolic pulmonary hypertension].
abstract: OBJECTIVE
  To evaluate 5-year results of surgical treatment of patients with chronic postembolic pulmonary hypertension.
  
  
  METHODS
  170 patients with chronic postembolic pulmonary hypertension underwent pulmonary thrombendarterectomy. Mean age was 48±21.5 years. The operation was carried out using standard technique with hypothermia and circulatory arrest. We have analyzed clinical and functional status of 47 patients (23 males) prior to surgery and in long-term postoperative period (5-6 years). Distance of 6-minute walk test, mean pulmonary artery pressure and vascular resistance according to right heart catheterization, RV ejection fraction and volumes according to echocardiography, pulmonary artery diameter according to CT-angiography were analyzed.
  
  
  RESULTS
  In remote postoperative period average distance of 6-minute walk test was increased by 2.8 times compared with initial values. Right heart catheterization revealed reduction of the average pulmonary pressure from 54.04±23.35 to 25.16±15.41 mmHg and vascular resistance from 539.66±120.59 dyn·sec·cm-5to 101.39±89.20 dyn·sec·cm-5. Echocardiography showed increase of RV EF from 36±2.3 to 51.8±4.1% and decrease of RV end-diastolic volume from 109.4±39.2 to 39.1±6.8 ml. According CT-angiography there was decrease of pulmonary trunk diameter from 35.10±5.25 to 30.30±8.65 mm.
  
  
  CONCLUSIONS
  Our 5-year data show that pulmonary thrombendarterectomy has high long-term effectiveness in patients with proximal form of chronic postembolic pulmonary hypertension.
authors.affiliation: Meshalkin Novosibirsk Research Institute of Circulation Pathology, Ministry of Health of the Russian Federation.
authors.forename: A M
authors.initials: AM
authors.lastname: Chernyavsky
authors.affiliation: Meshalkin Novosibirsk Research Institute of Circulation Pathology, Ministry of Health of the Russian Federation.
authors.forename: A G
authors.initials: AG
authors.lastname: Edemsky
authors.affiliation: Meshalkin Novosibirsk Research Institute of Circulation Pathology, Ministry of Health of the Russian Federation.
authors.forename: M A
authors.initials: MA
authors.lastname: Chernyavsky
authors.affiliation: Meshalkin Novosibirsk Research Institute of Circulation Pathology, Ministry of Health of the Russian Federation.
authors.forename: A R
authors.initials: AR
authors.lastname: Tarkova
authors.affiliation: Meshalkin Novosibirsk Research Institute of Circulation Pathology, Ministry of Health of the Russian Federation.
authors.forename: E N
authors.initials: EN
authors.lastname: Kliver
authors.affiliation: Meshalkin Novosibirsk Research Institute of Circulation Pathology, Ministry of Health of the Russian Federation.
authors.forename: S N
authors.initials: SN
authors.lastname: Ivanov
mesh_terms: D000328:Adult; D000368:Aged; D050792:Circulatory Arrest, Deep Hypothermia Induced / Q000379:methods*; D003935:Diagnostic Techniques, Cardiovascular; D004691:Endarterectomy / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D000069451:Long Term Adverse Effects / Q000175:diagnosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011184:Postoperative Period; D011655:Pulmonary Embolism / Q000150:complications*; D012426:Russia; D013318:Stroke Volume