Pulmonary thromboendarterectomy in chronic thromboembolic pulmonary hypertension: Evaluation of the surgical technique and postoperative care over report of a case

Abstract

Small number of patients with chronic pulmonary hypertension have surgical treatment alternative. Secondary pulmonary hypertension due to left heart diseases forms one of the groups that can be surgically treated as well as the chronic thromboembolic pulmonary hypertension (CTEPH) patients. A 58-year old female patient, who had been under medical treatment for CTEPH more than 7 years within the follow-up of different clinics attended to emergency clinic of our hospital with severe dyspnea and hemoptysis. Examinations revealed suprasystemic pulmonary hypertension and severe right ventricular heart failure. A successful pulmonary thromboendarterectomy was applied to the patient. In the immediate early postoperative period, pulmonary artery pressure decreased to 40 mmHg and right heart failure diminished. To elevate blood partial oxygen pressure to acceptable levels, mechanical ventilation and massive diuresis was necessary. The patient was discharged from hospital by the end of postoperative 3 rd week and her evaluation at our outpatient clinic two weeks later revealed that her functional capacity returned to NYHA class II. Surgical technique is evaluated with the help of the knowledge gathered in the literature. Copyright © 2011 by Türkiye Klinikleri.