Anesthesia management of pulmonary endarterectomy in patients with chronic thromboembolism

VernacularTitle:慢性血栓性肺动脉高压病人血栓内膜剥脱术的麻醉管理
Author: Chunxia SHI ; Mingzheng LIU ; Lihuan LI
Publication Type:Journal Article
Keywords: Hypertension,pulmonary; Endarterectomy; Anesthesia
From: Chinese Journal of Anesthesiology 2009;29(7):602-605
CountryChina
Language:Chinese
Abstract: Fifty-two patients with chronic thrombeembolism (41 male, 11 female) aged 33-67 yr underwent pulmonary endarterectomy between 1997-2008. Anesthesia was induced with etomidate, fentanyl/ sufentanil and rocuronium/vecuronium and maintained with large doses of narcotics supplemented with low concentrations of isoflurane/sevoflurane if necessary. Swan-Ganz catheter was placed after induction of anesthesia. Trausesophageal echocardiography was monitored. Bilateral pulmonary thromboembolism was performed using profound hypothermia with circulatory arrest. After operation, 35 patients still had sustained pulmonary hypertension (67%). Nervous system complications occurred in 7 patients ( 14% ). Six patients developed lung bleeding (12%) during and after operation and 4 patients infection (8%). The mortality was 15%.