| Autor: |
Cherniavskiĭ MA; Department of Cardiovascular Surgery No2, National Medical Research Centre named after V.A. Almazov under the RF Ministry of Public Health, Saint Petersburg, Russia., Edemskiĭ AG; Department of Aorta and Coronary Arteries, National Medical Research Centre named after Academician E.N. Meshalkin under the RF Ministry of Public Health, Novosibirsk, Russia., Kudaev IA; Department of Cardiovascular Surgery No2, National Medical Research Centre named after V.A. Almazov under the RF Ministry of Public Health, Saint Petersburg, Russia., Cherniavskiĭ AM; Department of Aorta and Coronary Arteries, National Medical Research Centre named after Academician E.N. Meshalkin under the RF Ministry of Public Health, Novosibirsk, Russia. |
| Jazyk: |
ruština |
| Zdroj: |
Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery [Angiol Sosud Khir] 2018; Vol. 24 (3), pp. 109-113. |
| Abstrakt: |
Analysed herein are the results of pulmonary endarterectomy (PEA) performed in a total of 169 patients presenting with chronic thromboembolic pulmonary hypertension (CTEPH) at the National Medical Research Centre named after Academician E.N. Meshalkin over the period from 2004 to 2014. Pulmonary endarterectomy was carried out according to the standard technique in the conditions of assisted circulation with the use of hypothermia and circulatory arrest. The duration of follow up of patients after surgical treatment amounted to 10 years. During the in-hospital period (30 postoperative days) and in the remote period after the intervention (averagely amounting to 7.7±2.3 years), the following parameters were evaluated: the clinical status of the patients by means of the SF-36 Quality of Life Questionnaire, the 6-minute walk test, as well as the findings of instrumental methods of study, namely, transthoracic echocardiography, multispiral computed angiography of the pulmonary artery (PA), catheterization of the right portions of the heart, perfusion scintigraphy of the lungs. The obtained results demonstrated that removal of thromboembolic obstruction of the PA was followed by significant improvement of intracardiac haemodynamics, volumetric-and-functional parameters of the right portions of the heart, pulmonary perfusion, accompanied by reverse remodelling of the right heart and lesser circulation (LC), which was manifested by a decrease in the following parameters: systolic and mean blood pressure in the PA, resistance of the LC vessels, total value of perfusion deficiency of the lung, as well as by a decrease in the dimensions of the right chambers of the heart and the diameter of the pulmonary trunk. Normalization of intracardiac haemodynamics resulted in improvement of the clinical and functional state of the patients both in the immediate and remote periods, which was confirmed by elevation of the scores on all scales of the SF-36 Quality of Life Questionnaire, a 2.25-fold increase in the distance walked over a span of 6 minutes, and a decrease in the functional class of chronic heart failure according to the NYHA classification. The obtained findings suggest high efficacy of performing PEA in patients with CTEPH, thus making it possible not only to prolong the lifespan of the patients but to increase their quality of life. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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