Peri-operative Management and Result of Pulmonary Endarterectomy in 56 Patients
10.3969/j.issn.1000-3614.2017.05.014
- VernacularTitle:肺动脉内膜剥脱术56例围手术期处理和结果报告
- Author:
Yuan LI
;
Jiade ZHU
;
Juan DU
;
Xin JIANG
;
Yan WU
;
Li SHI
;
Ge GAO
;
Song LOU
;
Bingyang JI
;
Jing YANG
;
Liming WU
;
Mingzheng LIU
;
Qin LUO
;
Zhihong LIU
;
Zhicheng JING
;
Yunhu SONG
;
Sheng LIU
- Keywords:
Hypertension,pulmonary;
Endarterectomy;
Peri-operative care
- From:
Chinese Circulation Journal
2017;32(5):480-484
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To summarize the peri-operative management experience of pulmonary endarterectomy (PEA) in patients with chronic thromboembolic pulmonary hypertension (CTEPH). Methods: A total of 56 CTEPH patients received PEA in our hospital from 2015-01 to 2016-11 were retrospectively analyzed. Our study was focused on the medication in respiratory and circulatory system during ICU stay, peri-operative application of vasoactive drug and target drug to pulmonary hypertension (HP), usage of ventilators, mechanical assisted devices and other management experiences. Results: No peri-operative death occurred. There were 2/56 (3.6%) patients with lung reperfusion, 2 (3.6%) with PH crisis. Compared with pre-operation, the post-operative pulmonary artery hemodynamics parameters were improved as right heart catheter measured pulmonary artery systolic pressure (PASP) decreased from (85.05±22.40) mmHg to (36.83 ±17.21) mmHg and pulmonary vascular resistance decreased from (773.84±342.95) dyn·s·cm-5 to (293.59±214.95) dyn·s·cm-5. Post-operative oxygen saturation was maintained at (95-100) % in all patients. Echocardiography found that PASP from pre-operation (85.03±25.78) mmHg decreased to (39.44±19.24) mmHg at follow-up period, P<0.01.Conclusion: A comprehensive peri-operative management of PEA was helpful to improve pulmonary hemodynamics in CTEPH patients; meanwhile, effective prevention and treatment of severe complication could obviously reduce peri-operative mortality.
