PT  - JOURNAL ARTICLE
AU  - N Tanabe
AU  - O Okada
AU  - Y Nakagawa
AU  - M Masuda
AU  - K Kato
AU  - N Nakajima
AU  - T Kuriyama
TI  - The efficacy of pulmonary thromboendarterectomy on long-term gas exchange
AID  - 10.1183/09031936.97.10092066
DP  - 1997 Sep 01
TA  - European Respiratory Journal
PG  - 2066--2072
VI  - 10
IP  - 9
4099  - http://erj.ersjournals.com/content/10/9/2066.short
4100  - http://erj.ersjournals.com/content/10/9/2066.full
SO  - Eur Respir J1997 Sep 01; 10
AB  - It has not been delineated in detail how pulmonary thromboendarterectomy (PTE) affects gas exchange through long-term follow-up. In Japan, this surgery has been undertaken in a limited number of institutions, and the results of PTE have not been well publicized. A total of 25 patients were operated on during the period from 1985 to 1996 at our institution, and the overall mortality rate was 16%. Our criteria for PTE were based on the following: 1) thrombi surgically accessible as judged by angiographic study; 2) mean pulmonary arterial pressure > or = 30 mmHg. The efficacies of PTE were analysed on haemodynamics as well as gas exchange at one month postsurgery and during follow-up (6-24 months). Significant haemodynamic improvement was obtained as early as 1 month after surgery. Improvement of gas exchange lagged, but was then observed during follow-up, and the improvement level of pulmonary haemodynamics was sustained. The early postoperative restrictive impairment and ventilation-perfusion abnormality on lung perfusion scan resolved during the follow-up period. It was concluded that the early postoperative efficacy of pulmonary throm-boendarterectomy was mainly achieved due to the reduction of pulmonary hypertension, whereas improvement in gas exchange was obtained over the longer term.