Pulmoner Tromboendarterektomi Tüm Dünyada Giderek Yaygınlaşmaktadır; Derleme

Year 2016, Volume: 19 Issue: 3, 184 - 190, 01.12.2016

Mehmet Yanartaş Rezzan Deniz Acar , Bedrettin Yıldızeli

Abstract

Pulmoner
tromboendarterektomi (PTE) kronik tromboembolik pulmoner hipertansiyonda
hemodinamik ve fonksiyonel iyileşmeyi sağlayan karmaşık bir cerrahi işlemdir.
PTE işlemi uygulaması tüm dünyada giderek yaygınlaşmakta ve cerrahi deneyim
arttıkça ölüm oranları her geçen gün giderek azalmaktadır. Başlangıçta %4 -24
gibi yüksek değerlerde olan cerrahi ölüm oranları tüm dünyada önemli oranda
düşmüştür.  PTE pulmoner arterleri
tıkayan ve erimemiş olan trombotik tıkacı çıkarmayı amaçlayan cerrahi bir
tekniktir. Kronik tromboemboliye bağlı pulmoner hipertansiyon olgularında  PTE işlemi sonrası pulmoner arter basıncı ve
pulmoner vasküler dirençte önemli ve sürekli değişiklikler gözlenmektedir. Son
günlerde, daha önceden cerrahi işlem için uygun olmadığı düşünülen bazı
olgulara bile artık PTE önerilmektedir.

Keywords

Pulmoner tromboendarterektomi, kronik tromboembolik pulmoner hipertansiyon

The Pulmonary Thromboendarterectomy Increases Gradually All Over the World; Review

Abstract

Pulmonary
endarterectomy (PTE) is a complex surgical procedure that provides functional
and haemodynamic improvement in patients with chronic thromboembolic pulmonary
hypertension. The use of PTE procedures is increasing all over the world and by
getting a high level of surgical expertise; therefore, mortality rates are
gradually decreasing day by day. Initially, operative mortality rates were high
with a range of approximately 4%-24%. These rates have substantially decreased
all over the world. PTE is a surgical technique that aims to remove unresolved
thromboembolic material that obstructs the pulmonary arteries. Significant and
persistent decreases in pulmonary artery pressures and pulmonary vascular
resistance are observed in patients with chronic thromboembolic pulmonary hypertension
after the surgery. Nowadays, this operation is offered to those patients who
were considered to be inoperable in the past.

Keywords

Pulmonary thromboendarterectomy, chronic thromboembolic pulmonary hypertension

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