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Endarterectomia Pulmonar en el Tratamiento de la Hipertensión Pulmonar Tromboembólica Crónica

Authors: Trillos Criado, Marcial;

Endarterectomia Pulmonar en el Tratamiento de la Hipertensión Pulmonar Tromboembólica Crónica

Abstract

Introducción: La Endarterectomia Pulmonar (EP) es el procedimiento quirúrgico mediante el cual se remueven trombos crónicos adheridos íntimamente a las paredes del árbol arterial pulmonar en el tratamiento de la Hipertensión Pulmonar Tromboembólica Crónica (HPTC). Tiene unas cinco décadas de desarrollo, es curativa, no es común su aplicación y su estudio ha sido escaso en nuestro medio. Objetivo: Describir las características de los pacientes con HPTC y resultados del tratamiento con EP. Materiales y métodos: Se describieron retrospectivamente una serie de nueve casos de pacientes sometidos a EP por HPTC desde Septiembre de 2009 hasta Septiembre de 2014. Se incluyeron pacientes con HPTC a quienes se les practicó EP sin importar la realización de otros procedimiento cardiovasculares de manera simultánea. Resultados: El 89% de los pacientes se operaron en condición de urgencia. El Euro-score promedio fue de 7,93. El NYHA pre-quirúrgico descrito fue III o IV. El 75% de los pacientes se operó sin arresto circulatorio. La presión sistólica en la arteria pulmonar (PSAP) pre-operatoria fue de 84,8 mmHg por Ecocardiograma Trastorácico (ETT) y la Presión de la Arteria Pulmonar Media (PAPM) de 46 mmHg por Cateterismo Cardiaco Derecho (CCD). Los cambios hemodinámicos registrados posteriores a la EP describen una reducción de 22% de la PSAP y del 40% de la PAPM. La mortalidad hospitalaria fue del 22%. Conclusión: Los resultados hemodinámicos de los pacientes con HPTC tratados con EP muestran un cambio favorable. Introduction: Pulmonary endarterectomy (EP) is the surgical procedure that removes adhered chronic thrombi closely to the walls of the pulmonary arterial tree in the treatment of Chronic Thromboembolic Pulmonary Hypertension (CTPH). It has about five decades of development, is curative, is not common application and its study has been lacking in our environment. Objective: To describe the characteristics of patients with CTPH and results of treatment with EP. Materials and methods: a series of nine cases of patients undergoing EP by CTPH from September 2009 to September 2014 were retrospectively described patients with CTPH who underwent EP regardless of the performance of other cardiovascular procedure were included simultaneously . Results: 89% of patients were operated in emergency condition. The Euro-score average was 7.93. The pre-operative NYHA III or IV was described. 75% of patients underwent surgery without circulatory arrest. Systolic pulmonary artery pressure (PASP) preoperative was 84.8 mmHg Transthoracic echocardiogram (TTE) and Pulmonary Artery Pressure Media (MPAP) of 46 mmHg Cardiac Catheterization Law (CCD). The hemodynamic changes after the EP described a reduction of 22% of the PSAP and 40% in MPAP. Hospital mortality was 22%. Conclusion: The hemodynamic results with CTEPH patients treated with EP show a favorable change.

Country
Colombia
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Keywords

Hipertensión pulmonar tromboembólica crónica, HIPERTENSION PULMONAR, Endarterectomia pulmonar, pulmonary endarterectomy, Chronic thromboembolic pulmonary hypertension, ENDARTERECTOMIA

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
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