PULMONARY ENDARTERECTOMY FOR CHRONIC THROMBOEMBOLIC OBSTRUCTION - RECENT SURGICAL EXPERIENCE

  • 1 January 1982
    • journal article
    • research article
    • Vol. 92  (6) , 1096-1102
Abstract
Pulmonary thromboendarterectomy for chronic pulmonary emboli was performed on 10 patients, ages 20-67 yr, between July 1977 and June 1981. Five patients each were assigned to New York Heart Association functional classes III and IV. All patients had pulmonary hypertension and increased pulmonary vascular resistance. Obstruction beginning in the lobar arteries and involving > 50% of the sequential arteries was present in all patients. Five patients had complete obstruction of a pulmonary artery. All patients had obstructive disease in both lungs. Pulmonary thromboendarterectomy was performed through central pulmonary arteriotomies and by use of deep hypothermia and circulatory arrest. Circulatory arrest was employed in 1-4 periods totaling up to 60 min. No neurologic deficit was observed. All patients developed reperfusion edema in the lungs. All patients had improvement in pulmonary hypertension and pulmonary vascular resistance. One patient died of lung failure in the late postoperative period. All survivors had improved lung function, with 2 functional classes in 7 patients. Improvement in 1 equaled 3 functional classes in 7 patients. Improvement in 1 equaled 3 functional classes and in 1, by 1 functional class.