2014 Volume 25 Issue 4 Pages 396-402
The prognosis is poor for patients with chronic thromboembolic pulmonary hypertension (CTEPH) accompanied by progressive right cardiac failure and respiratory failure. We performed a pulmonary thromboendarterectomy (PEA) using deep hypothermia and circulatory arrest on 9 such patients from May 2013 to October 2013 in Daiyukai General Hospital. Mean age was 61.4 years old and male/female was 3/6. Obstructive types of pulmonary artery were proximal type in 6 and distal type in 3 patients. Mean cardiopulmonary bypass time was 253 minutes, mean cardiac arrest time was 128 minutes and mean circulatory arrest time was 43 minutes. The surgical results and the postoperative quality of life in the 9 patients who tolerated the surgery well were examined. PEA using intermittent circulatory arrest under profound hypothermia was very effective in 9 patients. Postoperative respiratory and hemodynamic conditions were remarkably improved. However the management of CTEPH involved difficulties in selecting surgical patients and postoperative managements.
