Technique of Pulmonary Thromboendarterectomy for Chronic Pulmonary Embolism
作者:
PAT O. DAILY,
WALTER P. DEMBITSKY,
STEIN IVERSEN,
期刊:
Journal of Cardiac Surgery
(WILEY Available online 1989)
卷期:
Volume 4,
issue 1
页码: 10-24
ISSN:0886-0440
年代: 1989
DOI:10.1111/j.1540-8191.1989.tb00253.x
出版商: Blackwell Publishing Ltd
数据来源: WILEY
摘要:
AbstractPulmonary embolism infrequently results in severe chronic pulmonary arterial obstruction. However, when it does, affected patients are significantly symptomatic and have shortened survival. Medical management has proven ineffective. In the majority of surgical reports, unilateral thoracotomy with distal pulmonary arteriotomies has been emphasized. The average operative mortality was 22%. In this article, we discuss various preoperative considerations and describe in detail a surgical approach using median sternotomy for bilateral pulmonary thrombo‐endarterectomy with cardiopulmonary bypass, deep hypothermia and circulatory arrest. With this standardized approach in 103 consecutive patients from October 1, 1984, to September 20, 1988, the hospital mortality (death within 30 days or during hospitalization) has been 11.7
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