Search results for "Pulmonary thromboendarterectomy"
showing 10 items of 15 documents
Chronic Thromboembolic Pulmonary Hypertension: Pre- and Postoperative Assessment with Breath-hold MR Imaging Techniques
2004
To evaluate the potential of breath-hold magnetic resonance (MR) imaging techniques in morphologic and functional assessment of patients with chronic thromboembolic pulmonary hypertension (CTEPH) before and after surgery.Thirty-four patients with CTEPH were examined before and after pulmonary thromboendarterectomy (PTE). For morphologic assessment, contrast material-enhanced MR angiography was used; for assessment of hemodynamics, velocity-encoded gradient-echo sequences and cine gradient-echo sequences along the short axis of the heart were performed. Contrast-enhanced MR angiography was compared with selective digital subtraction angiography (DSA) for depiction of central thromboembolic m…
Improvement of tricuspid regurgitation after pulmonary thromboendarterectomy
2002
For patients with chronic thromboembolic pulmonary hypertension who undergo pulmonary thromboendarterectomy (PTE) it has not yet been systematically investigated how operation affects the severity of tricuspid regurgitation (TR). This study sought (1) to evaluate the extent of TR reversibility after operation, (2) to identify potential predictors of the reversibility of TR, and (3) to investigate the influence of geometric and hemodynamic alterations on the extent of TR severity.Thirty-nine patients (55+/-12 years) undergoing PTE without tricuspid valve repair were investigated before and 13+/-8 days after operation by Doppler color flow mapping. Geometry of the tricuspid valve as well as r…
Spiral CT of bronchial arteries in chronic thromboembolism.
1994
OBJECTIVE: Computed tomography study of bronchial artery anatomy and evaluation of dilatation and tortuousity as indicators for pulmonary hypertension and surgical risk in patients with chronic thromboembolism were performed. MATERIALS AND METHODS: We retrospectively reviewed contrast-enhanced, thin section spiral CT scans of 39 patients undergoing pulmonary thromboendarterectomy. Findings were compared with mean pulmonary artery (PA) pressure in all, postoperative mortality in 33, and postoperative CT in 5 patients. Twenty patients without pulmonary hypertension served as controls. RESULTS: In the pulmonary hypertension group, 50 bronchial arteries were observed in 30 of 39 patients. Their…
Quantitative Assessment of Right Ventricular Volumes in Severe Chronic Thromboembolic Pulmonary Hypertension using Transthoracic Three-dimensional Ec…
2002
Evaluation of a three-dimensional reconstruction method to show the changes of right ventricular volume and systolic function when patients undergo pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension.In the examination of 11 patients (four female, seven male; age 56+/-10 years) before and after pulmonary thromboendarterectomy, end-diastolic and end-systolic right ventricular volumes were determined as a sum total of the calculated volumes of derived parallel slices of the right ventricle. Using a Tomtec workstation and a Vingmed CFM 800 echocardiography device, the acquired data were ECG-and respiration-triggered in the course of transthoracic examination, usin…
Thoracic research scholarship 1988: pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension at the University of California…
1990
At the University of California, San Diego pulmonary thromboendarterectomy (PTE) has emerged as an effective measure in the treatment of chronic thromboembolic pulmonary hypertension. Unresolved emboli become organized by incorporation into the vascular wall and may form strictures, webs, bands and/or membranous occlusions and cause pulmonary hypertension refractory to medical treatment. When pulmonary vascular resistance exceeds 300 dyn.sec.cm-5 and the vascular wall changes are located to begin at or proximal to the lobar artery level, surgery is indicated. The operation is performed using cardiopulmonary bypass, deep hypothermia and periods of circulatory arrest. The dissection of each s…
Inhaled iloprost in patients with chronic thromboembolic pulmonary hypertension: effects before and after pulmonary thromboendarterectomy.
2003
Abstract Background In primary pulmonary hypertension, aerosolized prostanoids selectively reduce pulmonary vascular resistance and improve right ventricular function. In this study, hemodynamic effects of inhaled iloprost, a stable prostacyclin analogue, were evaluated in patients with chronic thromboembolic pulmonary hypertension (CTEPH) before and early after pulmonary thromboendarterctomy (PTE). Methods Ten patients (mean age 49 years old [32 to 70 years old], New York Heart Association functional class III and IV) received a dose of 33 μg aerosolized iloprost immediately before surgery (T1), after intensive care unit admission (T2), and 12-hours postoperatively (T3). Effects on pulmona…
Assessment of cardiac performance using Tei indices in patients undergoing pulmonary thromboendarterectomy.
2002
This study was designed to evaluate left and right ventricular performance using Tei indices in patients with severe chronic thromboembolic pulmonary hypertension undergoing pulmonary thromboendarterectomy (PTE). The Doppler-derived indices are easily measurable indicators of ventricular function based on nongeometric assessment, which helps overcome some of the difficulties entailed in the geometric assessment of left ventricular (LV) and right ventricular (RV) function in pulmonary hypertension.The indices were derived for 24 patients (aged 54+/-14 years) before and after PTE. Calculation of these indices was based on the duration of two time intervals using the formula (A - B)/B, where A…
Pathophysiology of Impaired Right and Left Ventricular Function in Chronic Embolic Pulmonary Hypertension
2000
Study objectives: This study sought to evaluatethe pathophysiology of left and right heart failure in patients withchronic thromboembolic pulmonary hypertension (CTEPH) who werehospitalized to undergo pulmonary thromboendarterectomy (PTE). Design: Thirty-nine patients (16 women and 23 men;mean ± SD age, 55 ± 12 years) with severe CTEPH were examinedbefore and 13 ± 8 days after PTE by way of transthoracicechocardiography and right heart catheterization. Measurements and results: Examination resultsconfirmed in all cases that before surgery the right ventricles wereenlarged and systolic function was impaired. Moderate to severetricuspid valve regurgitation was observed. Left ventriculareccent…
Long-term results after thromboendarterectomy for chronic pulmonary embolism1
1999
Objective: In patients with chronic thromboembolic pulmonary hypertension, pulmonary vascular resistance (PVR) can be reduced by pulmonary thromboendarterectomy (PTE). In this study, long-term symptomatic and hemodynamic effects were investigated. Methods: Twenty-two patients (12 female, 10 male, mean age 40 years, preoperative NYHA functional class II/III/IV: n = 1/12/9) were re-evaluated 48‐72 months (mean 60 months) after surgery. In addition to clinical assessment, radiologic, hemodynamic and echocardiographic investigations were performed. Results: All patients reported a marked improvement of their clinical condition. At follow-up, 11 patients were identified as NYHA class I, 10 as NY…
Chronisches thromboembolisches Cor pulmonale bei schrittmacherassoziierten rechtsatrialen Thromben: Pulmonale Thrombendarteriektomie mit Elektrodenen…
2008
Life-threatening chronic cor pulmonale occurred in a 22-year-old woman with congenital 3 degrees atrioventricular block, 6 years after implantation of a pacemaker and 3 1/2 years after removal of the pacemaker (the electrodes were too firmly attached to be removed). The emboli originated from the right-atrial thrombi which had formed around the electrodes left in situ. The embolic source shrank during systemic administration of urokinase, initially 600,000 IU in 60 min, then 100,000 IU per hour, and pulmonary perfusion improved transiently. Nonetheless the patient became breathless on the slightest physical exertion. Recurrent syncopal attacks with marked increase of pulmonary artery pressu…