Abstract
Pulmonary endarterectomy, which 25 years ago was only performed at the University of California, San Diego (UCSD), is now widely recognized as an effective way of treating pulmonary hypertension as a result of chronic thromboembolic disease. The operation is carried out using cardiopulmonary bypass to achieve profound hypothermia and circulatory arrest, which results in the bloodless field necessary for the visibility required for this delicate operation.
The condition of pulmonary hypertension due to chronic thromboembolic disease remains under-diagnosed, and the efficacy of this treatment unrecognized.
Almost 4,000 operations have now been performed at UCSD, with a mortality in the range of 2% in very sick patients. The diagnosis, operative approach, and results are described.
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References
Riedel M, Stanek V, Widimsky J, Prerovsky I. Long-term follow-up of patients with pulmonary thromboembolism: late prognosis and evolution of hemodynamic and respiratory data. Chest. 1982;81(2):151–8.
Lang IM. Chronic thromboembolic pulmonary hypertension: not so rare after all. N Engl J Med. 2004;350(22):2236–8.
Nijkeuter M, Hovens MM, Davidson BL, Huiman MV. Resolution of thromboemboli in patients with acute pulmonary embolism: a systematic review. Chest. 2006;129(1):192–7.
Uchida Y, Oshima T, Hirose J, Sasaki T, Morizuki S, Morita T. Angioscopic detection of residual pulmonary thrombi in the differential diagnosis of pulmonary embolism. Am Heart J. 1995;130(4):854–9.
Moser K, Braunwald NS. Successful surgical intervention in severe chronic thromboembolic pulmonary hypertension. Chest. 1973;64(1):29–35.
Madani MM, Jamieson SW. Technical advances of pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension. Semin Thorac Cardiovasc Surg. 2006;18(3):243–9.
Madani MM, Auger WR, Pretorius V, Sakakibara N, Kerr KM, Kim NH, Fedullo PF, Jamieson SW. Pulmonary endarterectomy: recent changes in a single institution’s experience of more than 2700 patients. Ann Thorac Surg. 2012;94(1):97–103.
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Jamieson, S.W. (2018). Management of Chronic Thromboembolic Pulmonary Hypertension. In: Chaar, C. (eds) Current Management of Venous Diseases . Springer, Cham. https://doi.org/10.1007/978-3-319-65226-9_43
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DOI: https://doi.org/10.1007/978-3-319-65226-9_43
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