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Pulmonary endarterectomy. Initial report in a cardiology hospital
Luis Efrén Santos-Martínez1, Víctor Manuel Lozano-Torres, César Antonio Flores-García
1Instituto Mexicano del Seguro Social, Hospital de Cardiología, Departamento de Hipertensión Pulmonar y Función Ventricular Derecha. Ciudad de México, México
Background:
Currently the options for treatment of chronic thromboembolic pulmonary hypertension can be pulmonary endarterectomy, pulmonary angioplasty and pharmacological treatment.
Objective:
To show the feasibility of performing pulmonary endarterectomy in a cardiology hospital.
Methods:
From December 2013 to June 2014 a serie of consecutive cases was studied according to the guidelines of the Fifth World Symposium of Pulmonary Hypertension. Its antecedents, clinical characteristics, functional class, hemodynamics, exercise capacity were defined in pre and post-operative conditions.
Results:
Three cases, two males with A + blood group and one female O + with presence of antiphospholipid antibodies; the three patients with prior history of pulmonary embolism, obese, with dyspnea and syncope; preoperative systolic pulmonary pressures were 60, 50, 59 mm Hg, and post-operative 43, 33, 21 mm Hg; functional class III/IV vs. I/IV; walked meters 320, 266, 252 vs. 480, 527, 0, respectively. One patient died, not related to surgery, due to multiple organ failure 40 days after surgery.
Conclusions:
Pulmonary endarterectomy is a feasible procedure with clinical and hemodynamic improvement.
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