Postoperative Use of a Percutaneous Cardiopulmonary Support Device after Pulmonary Thromboendarterectomy for Chronic Thromboembolic Pulmonary Hypertension

Abstract

Chronic thromboembolic pulmonary hypertension (CTEPH) is resistant to the medical therapy. Today, pulmonary thromboendarterectomy is considered the only curative treatment. We performed pulmonary thromboendarterectomy in the patients with CTEPH from 2001. Most of the operation was successful, but in some of the cases deep pulmonary hypertension or massive pulmonary bleeding exist just after surgery. In this fatal condition, failed to wean from extra corporeal circulation, we tried to introduce a percutaneous cardiopulmonary support (PCPS) device. Here we evaluated the efficacy of postoperative PCPS use for 23 CTEPH patients. In 14 cases, we successfully weaned from PCPS and saved lives in 13 cases (60.9%). The hemodynamic and respiratory parameters were significantly improved after surgery. PCPS was effective for CTEPH patients with extended deep pulmonary hypertension or massive pulmonary bleeding just after pulmonary thromboendarterectomy.