초록접수 현황
| 17F-269 | 포럼 발표 |
Surgical Experience of Massive Pulmonoary Thromboembolism for 14 Years
Jiye Park¹, Jonghwan Moon², You Sun Hong¹, Sang-hyun Lim¹
¹Department of Thoracic and Cardiovascular Surgery, Ajou University Hospital, Ajou University School of Medicine, Gyeonggi-do, Republic of Korea., ²Division of Trauma Surgery, Department of Surgery, Ajou University Hospital, Ajou University School of Medicine, Gyeonggi-do, Republic of Korea
Purpose : Pulmonary thromboembolism(PTE) is a life-threatening diease with high mortality rate. We retrospectively reviewed surgical pulmonary embolectomy cases for 14 years.
Methods : A retrospective review of patients who received surgical pulmonary embolectomy with massive pulmonary thromboembolism from 2003 to 2016 was done. Surgical indication was patients who showed right or left main pulmonary artery massive thrombosis in CT scan or echocardiography and also had one of these symptoms; cardiopulmonary collapse, RV failure, NYHA 3 or 4.
Results : Among 31 patients in total, 15 male patients and 16 female patients were reviewed. Average age was 47.4 and there were 4 chronic PTE patients and 27 acute PTE patients. Among Chronic PTE patients, mortality rate was 25%(1/4). A 30-day mortality of acute PTE patients was 14.8%(4/27), long term mortality was 18.5%(5/27). Every patient showed NYHA 3 or 4 before operation with mean 3.4 and postoperative mean NYHA status was 1.3, all of the survived patients were discharged with NYHA status 1 except for 3 bedridden patients.
Right ventricular systolic pressure and tricuspid valve regurgitation were measured with preoperative or intraoperative echocardiography, which was 69.6mmhg and grade 1.75 in mean, respectively. Postoperative RVSP was 29.8mmhg showing statistically meaningful improvement(<0.001) and TR grade also decreased to 1.3 in mean. Mean CVP also decreased from 14.7mmhg to 6.1mmhg.(<0.001).
Conclusion : Our study showed satisfactory mortality rate less than 20% for surgical pulmonary embolectomy. Also our patients showed remarkable improvement with RVSP, CVP, NYHA status after operation and long term follow up showed good results, too.
Methods : A retrospective review of patients who received surgical pulmonary embolectomy with massive pulmonary thromboembolism from 2003 to 2016 was done. Surgical indication was patients who showed right or left main pulmonary artery massive thrombosis in CT scan or echocardiography and also had one of these symptoms; cardiopulmonary collapse, RV failure, NYHA 3 or 4.
Results : Among 31 patients in total, 15 male patients and 16 female patients were reviewed. Average age was 47.4 and there were 4 chronic PTE patients and 27 acute PTE patients. Among Chronic PTE patients, mortality rate was 25%(1/4). A 30-day mortality of acute PTE patients was 14.8%(4/27), long term mortality was 18.5%(5/27). Every patient showed NYHA 3 or 4 before operation with mean 3.4 and postoperative mean NYHA status was 1.3, all of the survived patients were discharged with NYHA status 1 except for 3 bedridden patients.
Right ventricular systolic pressure and tricuspid valve regurgitation were measured with preoperative or intraoperative echocardiography, which was 69.6mmhg and grade 1.75 in mean, respectively. Postoperative RVSP was 29.8mmhg showing statistically meaningful improvement(<0.001) and TR grade also decreased to 1.3 in mean. Mean CVP also decreased from 14.7mmhg to 6.1mmhg.(<0.001).
Conclusion : Our study showed satisfactory mortality rate less than 20% for surgical pulmonary embolectomy. Also our patients showed remarkable improvement with RVSP, CVP, NYHA status after operation and long term follow up showed good results, too.
책임저자: Sang-hyun Lim
Department of Thoracic and Cardiovascular Surgery, Ajou University Hospital, Ajou University School of Medicine, Gyeonggi-do, Republic of Korea
발표자: Jiye Park, E-mail : kuracistopjy@gmail.com