Original contributionSurgical pathology of pulmonary thromboendarterectomy: a study of 54 cases from 1990 to 2001
Section snippets
Study group
The authors reviewed medical records, operative reports, and surgical specimens from all patients who underwent pulmonary thromboendarterectomy procedures performed by G.C.A.M. at Mayo Clinic Rochester between January 1, 1990 and December 31, 2001. The study was approved by the Mayo Clinic Institutional Review Board.
Clinical findings
For each patient, gender and age at operation were recorded from the medical record, as well as a history of DVT, pulmonary embolism (PE), coagulation abnormality, autoimmune
General findings
Of the 54 patients, 30 (56%) were women and 24 (44%) were men. At the time of operation, patients ranged in age from 33 to 77 years (mean, 58 years).
Thrombosis and embolism
A history of DVT was present in 28 patients (52%), 16 (58%) of whom were men. Another man had a history of subclavian vein thrombosis. Of the 42 patients (78%) with a history of PE, 23 (55%) were women. Twenty-four patients (44%) had a history of both DVT and PE, 14 (58%) of whom were men.
Coagulopathy
All patients were evaluated for an underlying coagulation
Discussion
CTEPH is an insidious and often unrecognized disease. Diagnosis is often delayed or overlooked. In general, prognosis is poor; the 5-year survival in patients with a mean pulmonary artery pressure >30 mm Hg is only 30%, and that for patients with a mean pulmonary artery pressure >50 mm Hg is only 10%.15 Other than lung transplantation, PTE is the only effective therapeutic option for this disease. For selected patients, PTE offers the possibility for substantial improvement in symptoms,
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