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Preoperative transcatheter occlusion of bronchopulmonary collateral artery reduces reperfusion pulmonary edema and improves early hemodynamic function after pulmonary thromboendarterectomy.
- Source :
-
The Journal of thoracic and cardiovascular surgery [J Thorac Cardiovasc Surg] 2014 Dec; Vol. 148 (6), pp. 3014-9. Date of Electronic Publication: 2014 May 15. - Publication Year :
- 2014
-
Abstract
- Objective: The present study assessed the effectiveness of preoperative transcatheter occlusion of the bronchopulmonary collateral artery (PTOBPCA) in reducing reperfusion pulmonary edema after pulmonary thromboendarterectomy (PEA).<br />Methods: The data from 155 patients with chronic thromboembolic pulmonary hypertension at Anzhen Hospital, treated from January 2007 to August 2013, with PEA were retrospectively reviewed. The patients were classified into a control (group A, n = 87) and treated (group B, underwent PTOBPCA, n = 68) group. The reperfusion pulmonary edema incidence, mechanical ventilation and intensive care unit hospitalization duration, and hemodynamic function were compared between the 2 groups.<br />Results: Of the 87 patients in group A, 5 died in-hospital (5.7% mortality); no patient in group B died (0% mortality; P = .035). In group A, 9 patients (10.3%) required extracorporeal membrane oxygenation (ECMO) after PEA; 1 patient (1.5%) in group B required ECMO (chi-square test, P = .026, χ(2) = 4.980). Group B had shorter intubation and intensive care unit hospitalization times, lower mean pulmonary artery pressures and pulmonary vascular resistance, higher partial pressures of oxygen in arterial blood and oxygen saturation, and decreased medical expenditure compared with group A. During a mean 37.1 ± 21.4 months of follow-up, 3 patients in group A and 2 in group B died; however, the difference in the actuarial survival at 3 years postoperatively between the 2 groups was not statistically significant.<br />Conclusions: PTOBPCA can reduce the incidence of reperfusion pulmonary edema, shorten intensive care unit hospitalization and intubation duration, improve early hemodynamic function, and reduce ECMO usage after PEA.<br /> (Copyright © 2014 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Airway Extubation
Chi-Square Distribution
China epidemiology
Chronic Disease
Combined Modality Therapy
Female
Hospital Mortality
Humans
Hypertension, Pulmonary diagnosis
Hypertension, Pulmonary mortality
Hypertension, Pulmonary physiopathology
Incidence
Intensive Care Units
Kaplan-Meier Estimate
Length of Stay
Male
Middle Aged
Pulmonary Edema diagnosis
Pulmonary Edema etiology
Pulmonary Edema mortality
Pulmonary Edema physiopathology
Pulmonary Embolism diagnosis
Pulmonary Embolism mortality
Pulmonary Embolism physiopathology
Respiration, Artificial
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome
Balloon Occlusion adverse effects
Balloon Occlusion mortality
Collateral Circulation
Endarterectomy adverse effects
Endarterectomy mortality
Hemodynamics
Hypertension, Pulmonary therapy
Lung blood supply
Pulmonary Circulation
Pulmonary Edema prevention & control
Pulmonary Embolism therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1097-685X
- Volume :
- 148
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- The Journal of thoracic and cardiovascular surgery
- Publication Type :
- Academic Journal
- Accession number :
- 24929804
- Full Text :
- https://doi.org/10.1016/j.jtcvs.2014.05.024