Journal Article•
만성폐색전증으로 인한 폐동맥고혈압 환자에서 시행한 폐동맥내막절제술
About: This article is published in The Korean Journal of Thoracic and Cardiovascular Surgery.The article was published on 2006-08-01 and is currently open access. It has received 1 citations till now.
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TL;DR: It is thought that early surgical treatment along with making the proper diagnosis before the aggravation of right heart failure can help improve the quality of a patient’s life.
Abstract: Background: Diagnosing chronic pulmonary embolism at an early stage is difficult because of the patient’s nonspecific symptoms. This condition is not prevalent in Korea, and in fact, there have been only a few case reports on this in the Korean medical literature. We analyzed the surgical outcome of performing pulmonary thromboendarterectomy in patients with chronic pulmonary embolism. Material and Method: The study subjects included those patients who underwent surgery for chronic pulmonary embolism from 1996 to 2008. For making the diagnosis, echocardiography, chest CT and a pulmonary perfusion scan were performed on the patients who complained of chronic dyspnea. Result: Pulmonary endarterectomy was performed as follows: by incision via a mid-sternal approach (7 patients); by incision via a left posterolateral approach (1 patient); using the deep hypothermic circulatory arrest technique (4 patients); under ventricular fibrillation (3 patients); and under cardioplegic arrest (1 patient). The postoperative systolic pulmonary artery blood pressure significantly decreased from a preoperative value of 78.9±14.5 ㎜Hg to 45.6±17.6 ㎜Hg postoperatively (p=0.000). The degree of tricuspid regurgitation was less than grade Ⅱ after surgery. Two patients died early on, including one patient who had persistent pulmonary hypertension without improvement and right heart failure. Conclusion: Patients who have chronic pulmonary embolism are known to have a poor prognosis. However, we think that early surgical treatment along with making the proper diagnosis before the aggravation of right heart failure can help improve the quality of a patient’s life.