Thromboembolic obstruction of the pulmonary artery treated by endarterectomy

Endarterectomy of a totally occluded right pulmonary artery by median sternotomy with cardiopulmonary bypass and intermittent circulatory arrest is described. The nature of the thrombus encountered and brisk backbleeding from the endarterectomized vessels predicted the functional improvement seen in the patient postoperatively. Reperfusion edema, which often complicates pulmonary artery thromboendarterectomy, was not observed. Preoperative assessment, postoperative management, and technical aspects of the operative procedure used in treating patients with thromboembolic obstruction of the pulmonary arteries are discussed.