Tromboendarterectomía pulmonar: tratamiento quirúrgico del tromboembolismo pulmonar crónico bajo paro circulatorio con hipotermia profunda en un caso / Pulmonary thromboendarterectomy: surgical treatment of chronic pulmonary thromboembolism under circulatory arrest and with deep hypothermia in 1 case

ABSTRACT

Pulmonary thromboendarterectomy under circulatory arrest and deep hypothermia is presently a curative treatment for pulmonary hypertension secondary to chronic pulmonary artery thromboembolic occlusion, but is still not frequently performed around the world. We report here the first successful pulmonary thromboendarterectomy under circulatory arrest performed in Chile. The patient was a 37 years old white man, high school teacher, with a 5 months history of effort dyspnea and cough. Pulmonary hypertension secondary to chronic pulmonary thromboembolism was confirmed by angiography and echocardiography. The patient was operated on april 27, 1995. After the operation the patient had an enmediate and maintained normalization of his pulmonary hemodynamics. He presented periods of delirium that postponed mechanical ventilation disconnection until the 7th postoperative day, after which he had an uneventful neurological recovery. Before hospital discharge a control angiography showed complete patency of the pulmonary artery system with no evidence of residual thrombi. Presently he is enjoying a normal life and back to his teaching activities