Pulmonary thromboendarterectomy for chronic pulmonary thromboembolism in protein C deficiency.

Abstract

Pulmonary thromboendarterectomy was performed on a patient with chronic pulmonary thromboembolism showing thrombophilia. The patient was a 56-year-old female with the above condition complicated by congenital protein C deficiency. She was admitted to our hospital with severe dyspnea accompanied by right ventricular failure. A pulmonary arteriogram showed occlusion and stenosis from lobar to segmental arteries. Cardiac catheterization showed marked pulmonary hypertension. A lung perfusion scintigram revealed multiple defects in the right and left lungs. After the insertion of an inferior vena cava filter, she was operated on. Following a median sternotomy, thromboendarterectomy of the bilateral pulmonary arteries was performed using deep hypothermia and intermittent circulatory arrest. Circulatory arrest was employed in three periods totaling up to 36 minutes. After surgery, she had improvements in pulmonary hypertension and pulmonary vascular resistance. She maintained improved lung functions, and remained in the New York Heart Association functional class I for more than two years and eight months after surgery.

• Authors: Masato Yoshida, Nobuhiko Mukohara, Hidefumi Obo, Nobuchika Ozaki, Tsutomu Shida, Yutaka Okita
• Journal: The Japanese journal of thoracic and cardiovascular surgery : official publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai zasshi (Jpn J Thorac Cardiovasc Surg) Vol. 54 Issue 2 Pg. 70-4 (Feb 2006) ISSN: 1344-4964 [Print] Japan
• PMID: 16519132 (Publication Type: Case Reports, Journal Article)

Topics

• Endarterectomy
• Female
• Humans
• Hypertension, Pulmonary (etiology)
• Middle Aged
• Protein C Deficiency (complications, congenital)
• Pulmonary Circulation
• Pulmonary Embolism (surgery)