PMID- 16828301
OWN - NLM
STAT- MEDLINE
DCOM- 20061031
LR  - 20060724
IS  - 1010-7940 (Print)
IS  - 1010-7940 (Linking)
VI  - 30
IP  - 2
DP  - 2006 Aug
TI  - Pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension: is 
      deep hypothermia required?
PG  - 237-41; discussion 241-3
AB  - OBJECTIVE: To investigate whether deep (<20 degrees C) hypothermia is necessary 
      in patients undergoing pulmonary endarterectomy for chronic thromboembolic 
      pulmonary hypertension. METHODS: Between January 2004 and February 2005, 30 
      patients (New York Heart Association (NYHA) class III or IV) were randomly 
      assigned to increasing (1 degrees C) levels of moderate (28-32 degrees C) 
      hypothermic cardiopulmonary bypass (CPB), each study group including six 
      patients. Primary study endpoint was adverse neurological outcome. Overall 
      preoperative total pulmonary vascular resistance was 1110+/-192 dynes cm(-5). 
      RESULTS: Mean CPB and cross-clamp times, and core temperature at the time of 
      circulatory arrests were 129+/-39 min and 92+/-24 min, and 30.1+/-1.5 degrees C, 
      respectively. Circulatory arrest was induced 2+/-0.7 times and its mean total 
      duration was 10.3+/-5.2 min (range, 2-19 min). Postoperatively, three patients 
      (10%) belonging to the 31 degrees C (n=1) and 32 degrees C (n=2) groups suffered 
      from temporary neurological dysfunction. Postoperative mechanical ventilatory 
      support and ICU stay were 26.3+/-18.9 h and 6.6+/-8.5 days, respectively, and 
      uninfluenced by degree of hypothermia. There were no lung reperfusion injuries or 
      any other major complications. All patients had a significant hemodynamic 
      improvement. CONCLUSION: Results suggest that pulmonary endarterectomy can be 
      safely performed with moderate hypothermia and short periods of circulatory 
      arrests without the need of profound hypothermia.
FAU - Macchiarini, Paolo
AU  - Macchiarini P
AD  - Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, 
      Hannover, Germany. pmacchiarini@clinic.ub.es
FAU - Kamiya, Hiroyuki
AU  - Kamiya H
FAU - Hagl, Christian
AU  - Hagl C
FAU - Winterhalter, Michael
AU  - Winterhalter M
FAU - Barbera, Joan
AU  - Barbera J
FAU - Karck, Matthias
AU  - Karck M
FAU - Pomar, Jose
AU  - Pomar J
FAU - Haverich, Axel
AU  - Haverich A
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
DEP - 20060707
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  - Body Temperature
MH  - Chronic Disease
MH  - Endarterectomy/*methods
MH  - Female
MH  - Humans
MH  - Hypertension, Pulmonary/etiology/*surgery
MH  - Hypothermia, Induced/*methods
MH  - Intraoperative Care/methods
MH  - Male
MH  - Middle Aged
MH  - Postoperative Care/methods
MH  - Prospective Studies
MH  - Pulmonary Artery/*surgery
MH  - Pulmonary Embolism/complications/*surgery
EDAT- 2006/07/11 09:00
MHDA- 2006/11/01 09:00
CRDT- 2006/07/11 09:00
PHST- 2005/11/14 00:00 [received]
PHST- 2005/12/29 00:00 [revised]
PHST- 2006/02/20 00:00 [accepted]
PHST- 2006/07/11 09:00 [pubmed]
PHST- 2006/11/01 09:00 [medline]
PHST- 2006/07/11 09:00 [entrez]
AID - S1010-7940(06)00493-3 [pii]
AID - 10.1016/j.ejcts.2006.02.071 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2006 Aug;30(2):237-41; discussion 241-3. doi: 
      10.1016/j.ejcts.2006.02.071. Epub 2006 Jul 7.