PMID- 10875595
OWN - NLM
STAT- MEDLINE
DCOM- 20000717
LR  - 20190921
IS  - 0886-0440 (Print)
IS  - 0886-0440 (Linking)
VI  - 14
IP  - 5
DP  - 1999 Sep-Oct
TI  - Surgical treatment for chronic thromboembolic pulmonary hypertension under 
      profound hypothermia and circulatory arrest in 24 patients.
PG  - 377-85
AB  - BACKGROUND: Chronic thromboembolic pulmonary hypertension (CTEPH) is a serious 
      disease that induces hypoxemia and pulmonary hypertension, eventually leading to 
      respiratory failure and right heart failure. We evaluated the results of surgical 
      treatment in patients undergoing circulatory arrest under profound hypothermia. 
      METHODS: Between February 1995 and June 1999, 24 cases of CTEPH were surgically 
      treated. The age of patients (11 males and 13 females) ranged from 21 to 71 years 
      (mean 49+/-15 years). Because of hypoxemia, severe pulmonary hypertension (mean 
      pulmonary artery pressure 45+/-7 mmHg ), and low cardiac output, the functional 
      class of these patients was New York Heart Association (NYHA) III or IV. 
      Following a median sternotomy, profound hypothermia was induced using 
      cardiopulmonary bypass, and pulmonary thromboendarterectomy in the bilateral 
      pulmonary arteries was performed under intermittent circulatory arrest. Surgery 
      was performed emergently in four patients. RESULTS: Of these 24 patients, 2 of 20 
      patients who underwent elective surgery and 3 of 4 patients who underwent 
      emergent surgery died in the hospital. Symptoms of CTEPH markedly improved in 18 
      patients who survived the surgery. Pulmonary arterial pressure was decreased to 
      16+/-6 mmHg, and cardiac output was increased. CONCLUSIONS: When CTEPH is 
      resistant to medical treatment, surgical treatment is useful. When surgical 
      indications are carefully selected, pulmonary thromboendarterectomy using 
      intermittent circulatory arrest under profound hypothermia is quite effective for 
      treating CTEPH.
FAU - Ando, M
AU  - Ando M
AD  - Department of Cardiovascular Surgery, National Cardiovascular Center, Suita, 
      Osaka, Japan.
FAU - Okita, Y
AU  - Okita Y
FAU - Tagusari, O
AU  - Tagusari O
FAU - Kitamura, S
AU  - Kitamura S
FAU - Nakanishi, N
AU  - Nakanishi N
FAU - Kyotani, S
AU  - Kyotani S
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Card Surg
JT  - Journal of cardiac surgery
JID - 8908809
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cardiac Output, Low/diagnosis/mortality/surgery
MH  - Chronic Disease
MH  - Emergencies
MH  - Endarterectomy
MH  - Female
MH  - *Heart Arrest, Induced
MH  - Hospital Mortality
MH  - Humans
MH  - Hypertension, Pulmonary/diagnosis/mortality/*surgery
MH  - *Hypothermia, Induced
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Pulmonary Embolism/diagnosis/mortality/*surgery
EDAT- 2000/06/30 11:00
MHDA- 2000/07/25 11:00
CRDT- 2000/06/30 11:00
PHST- 2000/06/30 11:00 [pubmed]
PHST- 2000/07/25 11:00 [medline]
PHST- 2000/06/30 11:00 [entrez]
AID - 10.1111/j.1540-8191.1999.tb01014.x [doi]
PST - ppublish
SO  - J Card Surg. 1999 Sep-Oct;14(5):377-85. doi: 10.1111/j.1540-8191.1999.tb01014.x.