PMID- 10456400
OWN - NLM
STAT- MEDLINE
DCOM- 19990930
LR  - 20190513
IS  - 1010-7940 (Print)
IS  - 1010-7940 (Linking)
VI  - 16
IP  - 1
DP  - 1999 Jul
TI  - Angioscopic video-assisted pulmonary endarterectomy for post-embolic pulmonary 
      hypertension.
PG  - 38-43
AB  - OBJECTIVES: To assess whether the use of video-assisted angioscopy would increase 
      the outcome of pulmonary thromboendarterectomy (PTE). METHODS: PTE included a 
      median sternotomy, intrapericardial dissection of the superior vena cava, 
      institution of cardiopulmonary bypass, deep hypothermia and sequential 
      circulatory arrest periods. It was always performed through two separate 
      arteriotomies on both main intrapericardial pulmonary arteries, into which a 
      rigid 5 mm angioscope connected to a video camera was introduced to increase the 
      visibility and endarterectomies. RESULTS: From January 1996 to July 1998, 68 
      consecutive patients (35 males and 33 females) aged 54.3 +/- 13.5 years underwent 
      PTE. Patients were in New York Heart Association (NYHA) class II (n = 2), III (n 
      = 43) or IV (n = 23) with the following hemodynamics: mean pulmonary arterial 
      pressure (PAP) 54 +/- 13 mmHg; cardiac output (CO): 3.8 +/- 0.8 l/min, and total 
      pulmonary resistance (TPR): 1207 +/- 416 dyne x s x cm(-5). The cumulated 
      circulatory arrest time was 23 +/- 12 min and postoperative length of ventilatory 
      support 10 +/- 12 days. Nine patients died, for an overall in-hospital mortality 
      of 13.2%. The functional outcome in surviving patients was significantly improved 
      (P < 0.0001) both clinically (NYHA class 3.2 +/- 0.5 vs. 1.3 +/- 0.6) and 
      hemodynamically (PAP (mmHg) 53.1 +/- 13 vs. 30.2 +/- 11.8, CI (l/min per m2) 2.1 
      +/- 0.5 vs. 2.8 +/- 0.6, TPR (dyne x s x cm(-5)) 1174 +/- 416 vs. 519 +/- 250). 
      CONCLUSIONS: Video-assisted angioscopy improves the quality and degree of 
      pulmonary endarterectomy expanding the indications to include patients with 
      previously inaccessible distal disease.
FAU - Dartevelle, P
AU  - Dartevelle P
AD  - Service of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie 
      Lannelongue Hospital, Paris-Sud University, Le Plessis Robinson, France. 
      phdart@pratique.fr
FAU - Fadel, E
AU  - Fadel E
FAU - Chapelier, A
AU  - Chapelier A
FAU - Macchiarini, P
AU  - Macchiarini P
FAU - Cerrina, J
AU  - Cerrina J
FAU - Parquin, F
AU  - Parquin F
FAU - Simonneau, F
AU  - Simonneau F
FAU - Simonneau, G
AU  - Simonneau G
LA  - eng
PT  - Journal Article
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
SB  - IM
MH  - Adult
MH  - Aged
MH  - *Angioscopy
MH  - Chronic Disease
MH  - *Endarterectomy
MH  - Female
MH  - Humans
MH  - Hypertension, Pulmonary/etiology/physiopathology/*surgery
MH  - Male
MH  - Middle Aged
MH  - Pulmonary Artery/*surgery
MH  - Pulmonary Embolism/complications
MH  - Treatment Outcome
MH  - Video Recording
EDAT- 1999/08/24 00:00
MHDA- 1999/08/24 00:01
CRDT- 1999/08/24 00:00
PHST- 1999/08/24 00:00 [pubmed]
PHST- 1999/08/24 00:01 [medline]
PHST- 1999/08/24 00:00 [entrez]
AID - S1010794099001165 [pii]
AID - 10.1016/s1010-7940(99)00116-5 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 1999 Jul;16(1):38-43. doi: 
      10.1016/s1010-7940(99)00116-5.