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thromboendarterectomy FOR CHRONIC PULMONARY THROMBOEMBOLISM

Chinese Medical Sciences Journal 2005年第3期20卷 194-197页

作者： Hua Ren Pi-xiong Su Chao-ji Zhang Song Gu Heng Zhang Chen Wang Department of Cardiovascular Surgery Peking Union Medical College Hospital Chinese Academy of Medical Sciences ＆ Peking Union Medical College Beijing 100730 Department of Cardiovascular Surgery Chaoyang Hospital Beijing 100007 Department of Respiratory Medicine Chaoyang Hospital Beijing 100007

Objective To evaluate the improving reliability and safety of.thromboendarterectomy and perioperative management for chronic pulmonary thromboembolism. Methods The clinical data of 12 cases with chronic pulmonary thromboembolism, who underwent thromboendarterec- tomy assisted by low flow or circulation arrest with deep hypothermia, were reviewed retrospectively. Results Pulmonary artery pressure decreased 20 to 40 mmHg immediately after surgical procedures in 9 cases. The postoperative pulmonary edema at various degrees happened in 12 cases, among them, 1 died of severe lung infection and pulmonary re-embolism at 19 days postoperation. Computed tomography pulmonary angiography and angiography of 11 cases indicated that the original obstruction of pulmonary artery disappeared. During the follow-up period of 2 months to 5 years, the clinical symptoms and activity was improved. Conclusion.thromboendarterectomy is an effective treatment for chronic pulmonary thromboembolism. The outcome of the surgical procedure needs to be further investigated and followed up regularly according to an evaluative system, because it might be influenced by multiple factors.

关键词： chronic pulmonary thromboembolism .thromboendarterectomy pulmonary hypertension postoperative pulmonary edema

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