Tromboendarterectomia pulmonar: tratamiento de elección para la hipertensión pulmonar tromboembólica crónica 18 a？os de seguimiento del Hospital Universitario Fundación Favaloro

pulmonary thromboendarterectomy is the treatment of choice for patients with chronic thromboembolic pulmonary hypertension. objective: to report our 18-years experience in pulmonary thromboendarterectomy. material and methods: forty one patients were analyzed between november/1992 and august/2010. inclusion criteria: mean pulmonary artery pressure (papm) >30 mmhg and pulmonary vascular resistance (pvr) >300 dinas/sec.cm-5. pulmonary angiography determined the surgical feasibility. survival was calculated using the kaplan-meier method and to compare the 2 groups log rank test. results: forty four percent of the patients were classified in class iv. the hemodynamic changes after pulmonary thromboendarterectomy were significant (p < 0.001). papm 53 ± 2 vs. 29 ± 2 mm hg, pvr 857 ± 65 vs. 245 ± 25 dinas/sec. cm-5 and ci 2.3 ± 0.1 vs. 3 ± 0.1. in-hospital mortality was 15%; in classes ii - iii was 4%, and in class iv 33% (p = 0.01). late mortality was 12%. ninety three percent of the patients improved their functional class. overall survival at 1, 2, 5 and 10 years was 85%, 82%, 75% and 71% respectively. survival according to functional class showed significant differences (p = 0.02). conclusion: in our experience pulmonary thromboendarterectomy showed benefits even in this high risk population.