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Technique of Pulmonary Thromboendarterectomy for Chronic Pulmonary Embolism
Author(s) -
DAILY PAT O.,
DEMBITSKY WALTER P.,
IVERSEN STEIN
Publication year - 1989
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.1989.tb00253.x
Subject(s) - medicine , pulmonary thromboendarterectomy , pulmonary embolism , thoracotomy , cardiopulmonary bypass , median sternotomy , hypothermia , endarterectomy , surgery , anesthesia , cardiology , chronic thromboembolic pulmonary hypertension , carotid arteries
A bstract Pulmonary embolism infrequently results in severe chronic pulmonary arterial obstruction. However, when it does, affected patients are significantly symptomatic and have shortened survival. Medical management has proven ineffective. In the majority of surgical reports, unilateral thoracotomy with distal pulmonary arteriotomies has been emphasized. The average operative mortality was 22%. In this article, we discuss various preoperative considerations and describe in detail a surgical approach using median sternotomy for bilateral pulmonary thrombo‐endarterectomy with cardiopulmonary bypass, deep hypothermia and circulatory arrest. With this standardized approach in 103 consecutive patients from October 1, 1984, to September 20, 1988, the hospital mortality (death within 30 days or during hospitalization) has been 11.7%.