Original articleCardiovascularJapanese Single-Center Experience of Surgery for Chronic Thromboembolic Pulmonary Hypertension
Section snippets
Patients
Between 1995 and 2004, 88 patients with a mean age of 52.3 ± 13.1 years (range, 19 to 79) underwent surgery for CTEPH at the National Cardiovascular Center, Osaka, Japan. Institutional approval for this study was obtained, and each patient in the study gave informed consent to serve as a subject. A total of 60% were female. There were two peaks in the distribution of age and sex: a small peak of young males with coagulation abnormality, and a large peak of middle-age females. By etiology of
Results
The median durations of profound hypothermic circulatory arrest, cardiopulmonary bypass, and surgery were 58 minutes (24 to 99), 217 minutes (119 to 434), and 355 minutes (240 to 715), respectively. Median amounts of bleeding and blood transfusion were 1,153 mL (103 to 3,150) and 737 mL (0 to 6,000), respectively. Forty-five patients (51.1%) required no blood transfusion. Thirty-eight patients (43.2%) were extubated within 24 hours of completion of surgery. The duration of mechanical
Comment
Since the San Diego group began performing pulmonary endarterectomy for CTEPH [1, 2, 3], the indications and procedures used for this surgery have become well established, and several reports of successful outcomes have been published [4, 5, 6]. However, surgery for CTEPH is still technically demanding and risky. For patients with distal pulmonary artery disease, surgery is more difficult and its outcome poor, even at San Diego [4, 5, 6].
In the present retrospective study, the overall outcome
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2021, International Journal of CardiologyCitation Excerpt :Chronic thromboembolic pulmonary hypertension (CTEPH) is caused by pulmonary artery stenosis or obstruction because of organised thrombi [1,2]. Pulmonary endarterectomy (PEA) is the standard treatment for CTEPH [2–8]. Although improvements in PEA technology provided better surgical outcomes [8,9], patients are not good candidates for PEA if they have a peripherally located organised thrombus and/or comorbidities [3].