Pulmoner Tromboendarterektomi Tüm Dünyada Giderek Yaygınlaşmaktadır; Derleme

Yıl 2016, Cilt: 19 Sayı: 3, 184 - 190, 01.12.2016

Mehmet Yanartaş Rezzan Deniz Acar , Bedrettin Yıldızeli

Öz

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.

Anahtar Kelimeler

Pulmoner tromboendarterektomi, kronik tromboembolik pulmoner hipertansiyon

The Pulmonary Thromboendarterectomy Increases Gradually All Over the World; Review

Öz

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.

Anahtar Kelimeler

Pulmonary thromboendarterectomy, chronic thromboembolic pulmonary hypertension

Kaynakça

• 1. Stein PD, Kayali F, Olson RE. Estimated case fatality rate of pulmonary embolism, 1979 to 1998. Am J Cardiol 2004;93:1197-9.
• 2. Korkmaz A, Ozlu T, Ozsu S, Kazaz Z, Bulbul Y. Long-term outcomes in acute pulmonary thromboembolism: the incidence of chronic thromboembolic pulmonary hypertension and associated risk factors. Clin Appl Thromb Hemost 2012;18:281-8. doi: 10.1177/1076029611431956.
• 3. Ribeiro A, Lindmarker P, Johnsson H, Juhlin-Dannfelt A, Jorfeldt L. Pulmonary embolism: one-year follow-up with echocardiography doppler and five-year survival analysis. Circulation 1999;99:1325-30.
• 4. Nijkeuter M, Hovens MM, Davidson BL, Huisman MV. Resolution of thromboemboli in patients with acute pulmonary embolism: a systematic review. Chest 2006;129:192-7.
• 5. Mo M, Kapelanski DP, Mitruka SN, Auger WR, Fedullo PF, Channick RN, et al. Reoperative pulmonary thromboendarterectomy. Ann Thorac Surg 1999;68:1770-6.
• 6. Hirsch AM, Moser KM, Auger WR, Channick RN, Fedullo PF. Unilateral pulmonary artery thrombotic occlusion: is distal arteriopathy a consequence? Am J Respir Crit Care Med 1996;154:491-6.
• 7. Presti B, Berthrong M, Sherwin RM. Chronic thrombosis of major pulmonary arteries. Hum Pathol 1990;21:601-6.
• 8. Yao W, Firth AL, Sacks RS, Ogawa A, Auger WR, Fedullo PF, et al. Identification of putative endothelial progenitor cells (CD34+CD133+Flk-1+) in endarterectomized tissue of patients with chronic thromboembolic pulmonary hypertension. Am J Physiol Lung Cell Mol Physiol 2009;296:L870-L878.
• 9. Galie` N, Kim NH. Pulmonary microvascular disease in chronic thromboembolic pulmonary hypertension. Proc Am Thorac Soc 2006;3: 571-6.
• 10. Thistlethwaite PA, Mo M, Madani MM, Deutsch R, Blanchard D, Kapelanski DP, et al. Operative classification of thromboembolic disease determines outcome after pulmonary endarterectomy. J Thorac Cardiovasc Surg 2002;124:1203-11.
• 11. Doyle RL, McCrory D, Channick RN, Simonneau G, Conte J; American College of Chest Physicians. Surgical treatments/interventions for pulmonary arterial hypertension: ACCP evidence-based clinical practice guidelines. Chest 2004;126(Suppl 1):S63-S71.
• 12. Pepke-Zaba J, Delcroix M, Lang I, Mayer E, Jansa P, Ambroz D, et al. Chronic thromboembolic pulmonary hypertension (CTEPH): results from an international prospective registry. Circulation 2011;124:1973-81.
• 13. Vuylsteke A, Sharples L, Charman G, Kneeshaw J, Tsui S, Dunning J, et al. Circulatory arrest versus cerebral perfusion during pulmonary endarterectomy surgery (PEACOG): a randomised controlled trial. Lancet 2011;378:1379-87.
• 14. Kim NH, Fesler P, Channick RN, Knowlton KU, Ben-Yehuda O, Lee SH, et al. Preoperative partitioning of pulmonary vascular resistance correlates with early outcome after thromboendarterectomy for chronic thromboembolic pulmonary hypertension. Circulation 2004;109:18-22.
• 15. Hardziyenka M, Reesink HJ, Bouma BJ, de Bruin-Bon HA, Campian ME, Tanck MW, et al. A novel echocardiographic predictor of in-hospital mortality and mid-term haemodynamic improvement after pulmonary endarterectomy for chronic thrombo-embolic pulmonary hypertension. Eur Heart J 2007;28:785-7.
• 16. Guillinta P, Peterson KL, Ben-Yehuda O. Cardiac catheterization techniques in pulmonary hypertension. Cardiol Clin 2004;22:401-5. Heinrich M, Uder M, Tscholl D, et al. CT scan findings in chronic thromboembolic pulmonary hypertension. Chest 2005;127:1606-13.
• 17. Nikolaou K, Schoenberg SO, Attenberger U, Scheidler J, Dietrich O, Kuehn B, et al. Pulmonary arterial hypertension: diagnosis with fast perfusion MR imaging and high-spatial-resolution MR angiography-preliminary experience. Radiology 2005;236:694-703.
• 18. Fedullo PF, Auger WR, Kerr KM, Rubin LJ. Chronic thromboembolic pulmonary hypertension. N Engl J Med 2001;345:1465-72.
• 19. Kramm T, Eberle B, Guth S, Mayer E. Inhaled iloprost to control residual pulmonary hypertension following pulmonary endarterectomy. Eur J Cardiothorac Surg 2005;28:882-8.
• 20. Mares P, Gilbert TB, Tschernko EM, Hiesmayr M, Muhm M, Herneth A, et al. Pulmonary artery thromboendarterectomy: a comparison of two different postoperative treatment strategies. Anesth Analg 2000;90:267-73.
• 21. Kerr KM, Auger WR, Marsh JJ, Devendra G, Spragg RG, Kim NH, et al. Efficacy of methylprednisolone in preventing lung injury following pulmonary thromboendarterectomy. Chest 2012;141:27-35.
• 22. Yildizeli B, Tas S, Yanartas M, Kaymaz C, Mutlu B, Karakurt S, et al. Eur J Cardiothorac Surg 2013;44:e219-27.
• 23. Dartevelle P, Fadel E, Mussot S, Chapelier A, Herve´ P, de Perrot M, et al. Chronic thromboembolic pulmonary hypertension. Eur Respir J 2004;23:637-48.
• 24. Jamieson SW, Kapelanski DP. Pulmonary endarterectomy. Curr Probl Surg 2000;37:165-252.
• 25. Sitbon O, Humbert M, Nunes H, Parent F, Garcia G, Hervé P, et al. Long-term intravenous epoprostenol infusion in primary pulmonary hypertension: prognostic factors and survival. J Am Coll Cardiol 2002;40:780-8.
• 26. Orens JB, Estenne M, Arcasoy S, Conte JV, Corris P, Egan JJ, et al. International guidelines for the selection of lung transplant candidates: 2006 update-a consensus report from the Pulmonary Scientific Council of the International Society for Heart and Lung Transplantation. J Heart Lung Transplant 2006;25:745-55.
• 27. Trulock EP, Edwards LB, Taylor DO, Boucek MM, Keck BM, Hertz MI; International Society for Heart and Lung Transplantation. Registry of the International Society for Heart and Lung Transplantation: twenty-third official adult lung and heart-lung transplantation report-2006. J Heart Lung Transplant 2006;25:880-92.
• 28. Bresser P, Pepke-Zaba J, Jaïs X, Humbert M, Hoeper MM. Medical therapies for chronic thromboembolic pulmonary hypertension: an evolving treatment paradigm. Proc Am Thorac Soc 2006;3:594-600.
• 29. Jaïs X, D’Armini AM, Jansa P, Torbicki A, Delcroix M, Ghofrani H. Bosentan for treatment of inoperable chronic thromboembolic pulmonary hypertension: BENEFit (Bosentan Effects in iNopErable Forms of chronic Thromboembolic pulmonary hypertension), a randomized, placebo-controlled trial. J Am Coll Cardiol 2008;52:2127-34.
• 30. Ghofrani HA, D’Armini AM, Grimminger F, Hoeper MM, Jansa P, Kim NH, et al; CHEST-1 Study Group. Riociguat for the treatment of chronic thromboembolic pulmonary hypertension 2013;369:319-29. doi: 10.1056/NEJMoa1209657.
• 31. Ando M, Okita Y, Tagusari O, Kitamura S, Nakanishi N, Kyotani S. Surgical treatment for chronic thromboembolic pulmonary hypertension under profound hypothermia and circulatory arrest in 24 patients. Card Surg 1999;14:377-85.
• 32. D’Armini AM, Zanotti G, Viganò M. Pulmonary endarterectomy: the treatment of choice for chronic thromboembolic pulmonary hypertension. Ital Heart J 2005;6:861-8.
• 33. Hagl C, Khaladj N, Peters T, Hoeper MM, Logemann F, Haverich A, et al. Technical advances of pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension. Eur J Cardiothorac Surg 2003;23:776-81.
• 34. Mellemkjaer S, Ilkjaer LB, Klaaborg KE, Christiansen CL, Severinsen IK, Nielsen-Kudsk JE, et al. Pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension. Ten years experience in Denmark. Scand Cardiovasc J 2006;40:49-53.
• 35. Menzel T, Wagner S, Kramm T, Mohr-Kahaly S, Mayer E, Braeuninger S, et al. Pathophysiology of impaired right and left ventricular function in chronic embolic pulmonary hypertension: changes after pulmonary thromboendarterectomy. Chest 2000;118:897-903.
• 36. Masuda M, Nakajima N. Our experience of surgical treatment for chronic pulmonary thromboembolism. Ann Thorac Cardiovasc Surg 2001;7:261-5.
• 37. Pulmonary Thromboendarterectomy (PTE) Assessment for Nationally Funded Centre Status. A report by the Medical Services Advisory Committee to the Australian Health Ministers’ Advisory Council. November, 2006.
• 38. Tscholl D, Langer F, Wendler O, Wilkens H, Georg T, Schäfers HJ. Pulmonary thromboendarterectomy--risk factors for early survival and hemodynamic improvement. Eur J Cardiothorac Surg 2001;19:771-6.
• 39. Lindner J, Jansa P, Kunstýr J, Bláha J, Grus T, Mlejnský F, et al. Pulmonary endarterectomy-the surgical treatment of chronic thromboembolic pulmonary hypertension. Cas Lek Cesk 2006;145:307-12.
• 40. Thomson B, Tsui SS, Dunning J, Goodwin A, Vuylsteke A, Latimer R, et al. Pulmonary endarterectomy is possible and effective without the use of complete circulatory arrest--the UK experience in over 150 patients. Eur J Cardiothorac Surg 2008;33:157-63.
• 41. Corsico AG, D’Armini AM, Cerveri I, Klersy C, Ansaldo E, Niniano R, et al. Long-term outcome after pulmonary endarterectomy. Am J Respir Crit Care Med 2008;178:419-24. doi: 10.1164/rccm.200801-101OC.
• 42. Narayana Iyengar RM, Hegde D, Chattuparambil B, Gupta R, Patil L. Postoperative management of pulmonary endarterectomy and outcome. Ann Card Anaesth 2010;13:22-7. doi: 10.4103/0971-9784.58830.
• 43. Blázquez JA, Escribano P, Pérez E, López MJ, Gómez MA, Cortina JM. Chronic thromboembolic pulmonary hypertension: surgical treatment with thromboendarterectomy. Arch Bronconeumol 2009;45:496-501. doi: 10.1016/j.arbres.2009.05.014.
• 44. Saouti N, Morshuis WJ, Heijmen RH, Snijder RJ. Long-term outcome after pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension: a single institution experience. Eur J Cardiothorac Surg 2009;35:947-52. doi: 10.1016/j.ejcts. 2009.01.023.
• 45. Gu S, Liu Y, Su PX, Zhai ZG, Yang YH, Wang C. Pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension: preliminary exploration in China. Chin Med J (Engl) 2010;123:979-83.
• 46. Freed DH, Thomson BM, Berman M, Tsui SS, Dunning J, Sheares KK, et al. Survival after pulmonary thromboendarterectomy: effect of residual pulmonary hypertension. J Thorac Cardiovasc Surg 2011;141:383-7. doi: 10.1016/j.jtcvs.2009.12.056.
• 47. Kunihara T, Gerdts J, Groesdonk H, Sata F, Langer F, Tscholl D, et al. Predictors of postoperative outcome after pulmonary endarterectomy from a 14-year experience with 279 patients. Eur J Cardiothorac Surg 2011;40:154-61. doi: 10.1016/j.ejcts.2010.10.043.
• 48. de Perrot M, McRae K, Shargall Y, Pletsch L, Tan K, Slinger P, et al. Pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension: the Toronto experience. Can J Cardiol 2011;27:692-7. doi: 10.1016/j.cjca.2011.09.009.
• 49. Ishida K, Masuda M, Tanabe N, Matsumiya G, Tatsumi K, Nakajima N. Long-term outcome after pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension. J Thorac Cardiovasc Surg 2012;144:321-6. doi: 10.1016/j.jtcvs.2011.09.004.
• 50. Oh SJ, Bok JS, Hwang HY, Kim KH, Kim KB, Ahn H. Clinical outcomes of thromboendarterectomy for chronic thromboembolic pulmonary hypertension: 12-year experience. Korean J Thorac Cardiovasc Surg 2013;46:41-8. doi: 10.5090/kjtcs.2013.46.1.41.