PMID- 20075531
OWN - NLM
STAT- MEDLINE
DCOM- 20100223
LR  - 20100915
IS  - 0974-5181 (Electronic)
IS  - 0971-9784 (Linking)
VI  - 13
IP  - 1
DP  - 2010 Jan-Apr
TI  - Postoperative management of pulmonary endarterectomy and outcome.
PG  - 22-7
LID - 10.4103/0971-9784.58830 [doi]
AB  - Pulmonary artery thromboendarterectomy (PTE) has been regarded as a promising, 
      potentially curative surgical procedure. However, PTE is associated with specific 
      postoperative complications, such as reperfusion pulmonary edema and right heart 
      failure leading to a considerable mortality of 7-24%. Despite its limitations PTE 
      is a better surgical alternative to lung transplantation which carries high 
      morbidity and mortality. The aim of the study is to analyze the efficacy, safety, 
      morbidity and survival associated in the postoperative period and quality of life 
      after six months of PTE in Indian patients. Forty-one patients with surgically 
      correctable chronic thromboembolic pulmonary hypertension underwent pulmonary 
      endarterectomy. All patients were in New York Heart Association (NYHA) Class II, 
      III or IV. Preoperative mean pulmonary artery pressure was 40.98 +/- 9.29 mmHg 
      and mean pulmonary vascular resistance was 418.39 +/- 95.88 dynes/sec/cm(-5). All 
      patients were followed up to six months and a telephonic survey was conducted 
      using a standard questionnaire. They were assessed and classified as per NYHA 
      grading. There was a significant reduction in the mean pulmonary artery pressure 
      (from 40.98 +/- 9.29 mmHg to 24.13 +/- 7.36 mmHg, P < 0.001) and pulmonary 
      vascular resistance (from 418.39 +/- 95.88 dynes/sec/cm(-5) to 142.45 +/- 36.27 
      dynes/sec/cm(-5), P < 0.001) with a concomitant increase in the cardiac index 
      (from 1.99 +/- 0.20 L/min/m 2 to 3.28 +/- 0.56 L/min/m 2 , P < 0.001) during the 
      postoperative period. The mortality rate in our study was 12.19% (five patients). 
      Ninety per cent of the patients reported a significant improvement in the quality 
      of life and exercise tolerance after surgery compared to the preoperative state. 
      Pulmonary endarterectomy is an effective and potentially curative surgical 
      treatment for patients with severe chronic thromboembolic pulmonary hypertension. 
      The current techniques of operation make the procedure relatively safe and 
      long-term survival, NYHA functional status and exercise capacity improve 
      significantly.
FAU - Narayana Iyengar, Ramakrishna M
AU  - Narayana Iyengar RM
AD  - Narayana Hrudayalaya Institute of Medical Sciences, Bangalore, India. 
      manvaram@yahoo.com
FAU - Hegde, Deviprasad
AU  - Hegde D
FAU - Chattuparambil, Binoy
AU  - Chattuparambil B
FAU - Gupta, Ratan
AU  - Gupta R
FAU - Patil, Lakshmi
AU  - Patil L
LA  - eng
PT  - Journal Article
PL  - India
TA  - Ann Card Anaesth
JT  - Annals of cardiac anaesthesia
JID - 9815987
SB  - IM
CIN - Ann Card Anaesth. 2010 Sep-Dec;13(3):264. PMID: 20826974
MH  - Adult
MH  - Endarterectomy/*adverse effects/mortality
MH  - Female
MH  - Humans
MH  - Hypertension, Pulmonary/psychology/*surgery
MH  - Male
MH  - Postoperative Complications/*therapy
MH  - Pulmonary Artery/*surgery
MH  - Quality of Life
MH  - Treatment Outcome
EDAT- 2010/01/16 06:00
MHDA- 2010/02/24 06:00
CRDT- 2010/01/16 06:00
PHST- 2010/01/16 06:00 [entrez]
PHST- 2010/01/16 06:00 [pubmed]
PHST- 2010/02/24 06:00 [medline]
AID - AnnCardAnaesth_2010_13_1_22_58830 [pii]
AID - 10.4103/0971-9784.58830 [doi]
PST - ppublish
SO  - Ann Card Anaesth. 2010 Jan-Apr;13(1):22-7. doi: 10.4103/0971-9784.58830.