Abstract

BALTAZARES LIPP, MARIO ENRIQUE et al. TROMBOENDARTERECTOMÍA PULMONAR BILATERAL EN UN CASO DE HIPERTENSIÓN ARTERIAL PULMONAR TROMBOEMBÓLICA CRÓNICA. Rev. Inst. Nal. Enf. Resp. Mex. [online]. 2004, vol.17, n.3, pp.192-197. ISSN 0187-7585.

Pulmonary embolism is a global public health problem with estimated annual incidence of 100,000 cases ion France, 65,000 in England and Wales, 630,000 in the United States and 60,000 new cases per year in Italy. Mortality of untreated cases can be up to 30% and with adequate treatment of 2-8%. Chronic thromboembolic pulmonary arterial hypertension occurs in 0.1 to 0.5% of patients who survive to the embolic event, and is the result of main pulmonary artery obstruction due to the presence of pulmonary embolia. Obstruction of the pulmonary vascular bed contributes to the development of pulmonary arterial hypertension, which determines diverse degrees of right ventricular dysfunction and modifies patient survival expectancy. Chronic thromboembolic pulmonary arterial hypertension is potentially corrigible by pulmonary thromboendaterectomy with extracorporeal circulation, deep hypothermia at 16°C and retrograde cerebral perfusion. The present article reports a case of chronic pulmonary thromboembolia with 70% obstruction of the pulmonary vascular bed and right ventricle dysfunction, subjected to bilateral pulmonary thromboendarterectomy. Visible improvements in hemodynamic, respiratory and functional state parameters were observed. These variables increase life quality and survival expectancy.

Keywords : Chronic thromboembolic pulmonary arterial hypertension; pulmonary embolia; thromboendarterectomy; extracorporeal circulation.