Resumen

PERADEJORDI, Margarita Ana; CANEVA, Jorge Osvaldo; GOMEZ, Carmen Beatriz  y  FAVALORO, Roberto René. CHRONIC THROMBOEMBOLIC PULMONARYHYPERTENSION: CLINICAL EVOLUTIONAND SURGICAL TREATMENT. Rev. Méd.-Cient. Luz Vida [online]. 2011, vol.2, n.1, pp. 5-9. ISSN 2219-8032.

Background: Chronic thromboembolic pulmonary hypertension is a complication of acute major pulmonary embolism or multiple episodes of pulmonary thromboembolism. Objective: It is to Analyze clinical and demographic characteristics and risk factors of our population with pulmonary thromboendar-terectomy. Methods: 43 consecutive patients with pulmonary thromboendar-terectomy were retrospectively analyzed between November 1992 and August 2010. Two patients were excluded for pulmonary angiosarcoma diagnosis. Selection criteria: dyspnea, mean pulmonary pressure >30mmHg, pulmonary vascular resistance >300 dyne/seg/ cm-⁵, complete blockage of a principal pulmonary artery, proximal obstruction of lobar or segmental arteries and no significant comor-bidities. 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 to severe tricuspid regurgitation. A history of deep vein thrombosis was identified in 52% of the cases, acute pulmonary embolism in 41% and 29% both. Thrombophilia was diagnosed in 51% of patients. During the postoperative, pulmonary pressures and resistan-ces showed a significant decrease (p <0,001). Overall survival at 1, 2, 5 and 10 years was 85%, 82%, 75% and 71% respectively with significant differences (p = 0,02). Conclusion: Pulmonary thromboendarterectomy was an effective treatment in high risk patients, improving hemodynamics and survival.

Palabras llave : Pulmonary hypertension; Pulmonary thromboendarterectomy; Pulmonary thromboembolism; Chronic thromboembolic pulmonary hypertension.