%0 Journal Article
%T Chronic thromboembolic pulmonary hypertension: clinical evolution and surgical treatment (Hipertensi車n pulmonar tromboemb車lica cr車nica: evoluci車n cl赤nica y tratamiento quir迆rgico)
%A Peradejordi Margarita Ana
%A C芍neva Jorge Osvaldo
%A Gomez Carmen Beatriz
%A Favaloro Roberto Ren谷
%J Revista M谷dico-Cient赤fica ※Luz y Vida§
%D 2011
%I Fraternidad Acad谷mica Cient赤fica Social M谷dica "Luz y Vida
%X Background: Chronic thromboembolic pulmonary hypertensionis a complication of acute major pulmonary embolism or multipleepisodes of pulmonary thromboembolism.Objective: It is to Analyze clinical and demographic characteristicsand risk factors of our population with pulmonary thromboendarterectomy.Methods: 43 consecutive patients with pulmonary thromboendarterectomywere retrospectively analyzed between November 1992and August 2010. Two patients were excluded for pulmonary angiosarcomadiagnosis. Selection criteria: dyspnea, mean pulmonarypressure >30mmHg, pulmonary vascular resistance >300 dyne/seg/cm-5, complete blockage of a principal pulmonary artery, proximalobstruction of lobar or segmental arteries and no significant comorbidities.The event-free survival was calculated using a Kaplan-Meier analysis. It was considered statistically significant a p-value≒ 0.05.Results: 44% of patients presented functional dyspnea class IV,61% severe dysfunction of right ventricular and 58% moderate tosevere tricuspid regurgitation. A history of deep vein thrombosiswas identified in 52% of the cases, acute pulmonary embolism in41% and 29% both. Thrombophilia was diagnosed in 51% of patients.During the postoperative, pulmonary pressures and resistancesshowed a significant decrease (p <0,001). Overall survival at 1,2, 5 and 10 years was 85%, 82%, 75% and 71% respectively withsignificant differences (p = 0,02).Conclusion: Pulmonary thromboendarterectomy was an effectivetreatment in high risk patients, improving hemodynamics and survival. -RESUMEN: Introducci車n: La hipertensi車n pulmonar tromboemb車lica cr車nicaes una complicaci車n de un embolismo pulmonar agudo mayor om迆ltiples episodios de tromboembolismo pulmonar.Objetivo: Analizar las caracter赤sticas cl赤nicas, demogr芍ficas y factoresde riesgo de nuestra poblaci車n con tromboendarterectom赤apulmonar.Material y M谷todos: Se analizaron retrospectivamente 43 pacientesconsecutivos con tromboendarterectom赤a pulmonar entreNoviembre 1992 y Agosto 2010. Dos pacientes fueron excluidosdel an芍lisis por diagn車stico de angiosarcoma pulmonar. Criteriosde selecci車n: disnea, presi車n arterial pulmonar media > 30 mmHg,resistencia vascular pulmonar > 300 dinas/seg/cm-5, obstrucci車ncompleta de una arteria pulmonar principal, obstrucci車n proximalde arterias lobares o segmentarias y ausencia de comorbilidadessignificativas. La supervivencia libre de eventos se calcul車 utilizandoun an芍lisis de Kaplan-Meier. Se consider車 estad赤sticamentesignificativo un valor de p ≒ 0.05.Resultados: Presentaban disnea en clase funcional IV el 44% delos pacientes, dis
%K Pulmonary hypertension
%K Pulmonary thromboendarterectomy
%K Pulmonary thromboembolism
%K Chronic thromboembolic pulmonary hypertension.
%U https://docs.google.com/viewer?a=v&pid=sites&srcid=ZGVmYXVsdGRvbWFpbnxyZXZtZWRpY29jaWVudGlmaWNhbHV6eXZpZGF8Z3g6NzVlYWQwNmZiNjkwZDdmMQ