Adquirindo expertise em tromboendarterectomia pulmonar: precisamos sempre seguir em frente!
| Autor: | Cláudio Léo Gelape, Ricardo de Amorim Corrêa, Rodrigo de Castro-Bernardes |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Hipertensão pulmonar Pulmonary thromboendarterectomy RC705-779 Hospital mortality Análise de sobrevivência business.industry Hypertension Pulmonary medicine.medical_treatment Pulmonary embolism Endarterectomy Thoracic Surgical Procedures Survival analysis Complicações pós-operatórias Pulmonary hypertension Postoperative complications Endarterectomia Diseases of the respiratory system Embolia pulmonar medicine Humans Original Article Mortalidade hospitalar Intensive care medicine business |
| Zdroj: | Jornal Brasileiro de Pneumologia, Volume: 47, Issue: 5, Article number: e20210427, Published: 01 DEC 2021 Jornal Brasileiro de Pneumologia, Vol 47, Iss 5 (2021) Jornal Brasileiro de Pneumologia |
| Popis: | Objectives Pulmonary endarterectomy (PEA) is the gold standard treatment for chronic thromboembolic pulmonary hypertension (CTEPH). This study aimed at reporting outcomes of CTEPH patients undergoing PEA within 10 years, focusing on advances in anesthetic and surgical techniques. Methods We evaluated 102 patients who underwent PEA between January 2007 and May 2016 at the Instituto do Coração do Hospital das Clínicas da Universidade de São Paulo. Changes in techniques included longer cardiopulmonary bypass, heating, and cooling times and mean time of deep hypothermic circulatory arrest and shortened reperfusion time. Patients were stratified according to temporal changes in anesthetic and surgical techniques: group 1 (January 2007–December 2012), group 2 (January 2013–March 2015), and group 3 (April 2015–May 2016). Clinical outcomes were any occurrence of complications during hospitalization. Results Groups 1, 2, and 3 included 38, 35, and 29 patients, respectively. Overall, 62.8% were women (mean age, 49.1 years), and 65.7% were in New York Heart Association functional class III–IV. Postoperative complications were less frequent in group 3 than in groups 1 and 2: surgical complications (10.3% vs. 34.2% vs. 31.4%, p=0.035), bleeding (10.3% vs. 31.5% vs. 25.7%, p=0.047), and stroke (0 vs. 13.2% vs. 0, p=0.01). Between 3 and 6 months post-discharge, 85% were in NYHA class I–II. Conclusion Improvements in anesthetic and surgical procedures were associated with better outcomes in CTEPH patients undergoing PEA during the 10-year period. |
| Databáze: | OpenAIRE |
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