Cor Vasa 2004, 45(11):552-555

Our initial experience with pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension

Jaroslav Lindner^1,*, Pavel Jansa², Jan Kunstýř³, Eckhard Mayer⁴, Tomáš Grus¹, Samuel Heller², Tomáš Paleček², Aleš Linhart², Michael Aschermann², Jan Tošovský¹

¹ II. chirurgická klinika kardiovaskulární chirurgie

² II. interní klinika kardiologie a angiologie

³ Klinika anesteziologie a resuscitace, Všeobecná fakultní nemocnice a 1. lékařská fakulta Univerzity Karlovy, Praha, Česká republika

⁴ Klinik für Herz-, Torax- und Gefäßchirurgie, Johannes Gutenberg Universität, Mainz, Německo

Chronic thromboembolic pulmonary hypertension is the sequel of multiple pulmonary embolism. A relatively rare condition, it can be treated successfully by pulmonary endarterectomy (PEA) in cases where central branches of the pulmonary artery are involved. The procedure is to be performed "on pump", in deep hypothermia, and in complete circulatory arrest during actual endarterectomy. When properly indicated and successfully operated, the procedure leads to marked improvement of functional fitness, cardiac output and a decrease in tricuspid regurgitation as a result of decreased pulmonary artery pressure. A prerequisite for success is an interdisciplinary approach. The authors present the case reports of the first two patients successfully operated on, with pulmonary artery pressure normalization obtained virtually in either case. It is estimated there may be some 10-20 PEA candidates in the Czech Republic each year.

Keywords: Chronic thromboembolic pulmonary hypertension; Pulmonary endarterectomy; Circulatory arrest; Deep hypo-thermia

Published: November 1, 2004  Show citation