Pulmonary Thromboendarterectomy

Pulmonary embolism (PE) affects 0.5-1 per 1000 people in the general population each year, and is one of the most common preventable causes of death among hospitalized patients. Unfortunately the diagnosis is missed more often than it is made, because PE often causes only vague and nonspecific symptoms. The clinical diagnosis of PE is unreliable and must be confirmed objectively with ventilation perfusion scanning or CT-angiography. Cardiogenic shock or systolic hypotension (BP 90mmHg), and presence of right- ventricular dysfunction or two principal criteria which govern the severity of PE. Chronic thromboembolic disease develops in only 0.5% of patients with a clinically recognized acute P.E. Most patients diagnosed with chronic PE have no antecedent history of acute emboli. We frequently detect pulmonary hypertension even when less than 50% of the vascular bed is occluded by thrombus. This process may lead to an inoperable situation. Themostcommonsymptomassociatedwith thromboembolic pulmonary, hypertension, as other of pulmonary hypertension, is exertional dyspnea syncope or presyncope is another common symptom in pulmonary hypertension. Currently, pulmonary angiography remains the gold standard for diagnosis of chronic thromboembolic pulmonary hypertension. Patients over age 40 undergo coronary arteriography and other cardiac investigations as necessary. Chronic anticoagulation represents the main stay of medical regimen because of the bronchial circulation, pulmonary embolism, seldom results in tissue necrosis. Pulmonary endarterectomy appears to be permanently curative. The severity of pulmonary hypertension at the time of diagnosis inversely correlates with duration of survival in this article we report 1 case of successful pulmonary thrombo endarterectomy (PTE), focusing on the surgical technique and outcome of the patient underwent PTE for chronic thromboembolic pulmonary hypertension. Cardiac surgery Department, shahid Rajaee Heart Center, Tehran, Iran.