PMID- 8651785
OWN - NLM
STAT- MEDLINE
DCOM- 19960722
LR  - 20161123
IS  - 0003-4975 (Print)
IS  - 0003-4975 (Linking)
VI  - 61
IP  - 6
DP  - 1996 Jun
TI  - Mid-term results of pulmonary thromboendarterectomy for chronic thromboembolic 
      pulmonary hypertension.
PG  - 1788-92
AB  - BACKGROUND: In patients with chronic thromboembolic pulmonary hypertension, acute 
      and striking decreases of pulmonary artery pressures and vascular resistance can 
      be achieved by pulmonary thromboendarterectomy. In this study, the long-term 
      effects of pulmonary thromboendarterectomy on hemodynamic indices and right 
      ventricular function were investigated. METHODS: Sixty-five patients (31 women 
      and 34 men; mean age, 47 +/- 17 years; range, 19 to 69 years; New York Heart 
      Association [NYHA] functional class II, n = 3; class III, n = 38; class IV, n = 
      24) were reassessed 13 to 48 months (mean, 27 months) after pulmonary 
      thromboendarterectomy. Measurements are reported as mean +/- standard deviation. 
      RESULTS: All patients reported a significant improvement of symptoms: 46 patients 
      were in NYHA functional class I, 16 patients in class II, and 3 patients in class 
      III. Mean pulmonary vascular resistance was significantly reduced compared with 
      preoperative and postoperative values (preoperative: 1,015 +/- 454 dynes.s.cm-5; 
      postoperative: 322 +/- 154 dynes.s.cm-5; follow-up: 198 +/- 72 dynes.s.cm-5; p < 
      0.001 versus preoperative; p < 0.025 versus postoperative). Concomitantly, 
      cardiac index was significantly increased compared with preoperative values 
      (preoperative: 2.0 +/- 0.7 L.min-1.m-2; follow-up: 2.9 +/- 0.5 L.min-1.m-2; p < 
      0.001). Significant reductions of right ventricular dimensions and recovery of 
      right ventricular function could be demonstrated radiologically and 
      echocardiographically. In 3 patients (preoperative NYHA class IV, NYHA class III 
      at follow-up) with proven coagulation abnormalities, pulmonary vascular 
      resistance was moderately increased at follow-up compared with postoperative 
      measurements. CONCLUSIONS: In patients with chronic thromboembolic pulmonary 
      hypertension, a persistent decrease of pulmonary vascular resistance and 
      improvement of right ventricular function and NYHA functional status can be 
      achieved by pulmonary thromboendarterectomy.
FAU - Mayer, E
AU  - Mayer E
AD  - Department for Cardiothoracic, Johannes Gutenberg-University Hospital Mainz, 
      Germany.
FAU - Dahm, M
AU  - Dahm M
FAU - Hake, U
AU  - Hake U
FAU - Schmid, F X
AU  - Schmid FX
FAU - Pitton, M
AU  - Pitton M
FAU - Kupferwasser, I
AU  - Kupferwasser I
FAU - Iversen, S
AU  - Iversen S
FAU - Oelert, H
AU  - Oelert H
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
MH  - Adult
MH  - Aged
MH  - Angiography, Digital Subtraction
MH  - Blood Coagulation Disorders/complications/physiopathology
MH  - Cardiac Output
MH  - Catheterization, Swan-Ganz
MH  - Chronic Disease
MH  - Echocardiography
MH  - *Endarterectomy
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Hypertension, Pulmonary/*surgery
MH  - Male
MH  - Middle Aged
MH  - Pulmonary Artery/diagnostic imaging/surgery
MH  - Pulmonary Wedge Pressure
MH  - *Thrombectomy
MH  - Thromboembolism/complications
MH  - Vascular Resistance
MH  - Ventricular Function, Right
EDAT- 1996/06/01 00:00
MHDA- 1996/06/01 00:01
CRDT- 1996/06/01 00:00
PHST- 1996/06/01 00:00 [pubmed]
PHST- 1996/06/01 00:01 [medline]
PHST- 1996/06/01 00:00 [entrez]
AID - 0003-4975(96)00169-5 [pii]
AID - 10.1016/0003-4975(96)00169-5 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 1996 Jun;61(6):1788-92. doi: 10.1016/0003-4975(96)00169-5.