Surgical Outcome of Two Difficult Cases with Predominant Proximal Pulmonary Artery Lesions of Chronic Thromboembolic Pulmonary Hypertension

Takashi Murashita; Hitoshi Ogino; Hitoshi Matsuda; Hiroaki Sasaki; Hiroshi Tanaka; Yutaka Iba; Keitaro Doumae; Tatsuki Fujiwara; Masatoshi Shimada; Naoki Okuda

doi:10.3400/avd.cr.11.00003

Case Reports

Surgical Outcome of Two Difficult Cases with Predominant Proximal Pulmonary Artery Lesions of Chronic Thromboembolic Pulmonary Hypertension

Takashi Murashita, Hitoshi Ogino, Hitoshi Matsuda, Hiroaki Sasaki, Hiroshi Tanaka, Yutaka Iba, Keitaro Doumae, Tatsuki Fujiwara, Masatoshi Shimada, Naoki Okuda

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Keywords: chronic thromboembolic pulmonary hypertension, pulmonary endarterectomy, proximal lesion, distal lesion

JOURNAL FREE ACCESS

2011 Volume 4 Issue 2 Pages 157-160

DOI https://doi.org/10.3400/avd.cr.11.00003

View "Advance Publication" version (June 2, 2011).

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Abstract

Pulmonary endarterectomy (PEA) for chronic thromboembolic pulmonary hypertension (CTEPH) is still challenging. The outcome of patients with proximal pulmonary artery disease is generally better than that of a distal lesion. However, we experienced poor results in two difficult cases having predominant proximal lesions even after effective PEA. Both of them had a long-time history of CTEPH and preoperative condition was critical. Although relatively large amount of thickened intima with massive thrombi were extracted from the proximal pulmonary arteries, they required postoperative percutaneous cardiopulmonary support due to residual pulmonary hypertension. Both of them finally died from pulmonary bleeding and adult respiratory distress syndrome.

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