PMID: 16639932Apr 28, 2006Paper

Pulmonary endarterectomy--the surgical treatment of chronic thromboembolic pulmonary hypertension

Casopís lékar̆ů c̆eských
J LindnerM Stríteský

Abstract

Chronic thromboembolic pulmonary hypertension (CTEPH) in indicated cases can be successfully treated by the endarterectomy of pulmonary arteries (PEA). Symptomatically not treated CTEPH has highly unfavourable prognosis. Five years survival of patients with mean pulmonary pressure over 50 mmHg is only 10%. PEA was not available in the Czech Republic till 2004, when PEA program was initiated it the Cardiocenter of the General teaching hospital in Prague in collaboration with leading clinics in that field (Prof. Mayer, University of Mainz, BRD). Up-to-date surgical technique, which in various modifications has been used at majority of clinics, was elaborated by Jamieson and Daily at University of California in San Diego. It is based on reverse endarterectomy performed during complete circulatory arrest with brain protection by deep hypothermia. Till September 2005 twelve patients were operated with zero mortality. In one patient a suture of atrial septum defect was necessary to perform along. Average time of the circulatory arrest was 45 minutes; duration of the extracorporal circulation was 334 minutes. Average duration of the operation was 450 minutes. Duration of the mechanical ventilation was in average 45.5 hours. After one ...Continue Reading

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