TITLE

Pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension: is deep hypothermia required?

AUTHOR(S)
Macchiarini, Paolo; Kamiya, Hiroyuki; Hagl, Christian; Winterhalter, Michael; Barbera, Joan; Karck, Matthias; Pomar, Jose; Haverich, Axel
PUB. DATE
August 2006
SOURCE
European Journal of Cardio-Thoracic Surgery;Aug2006, Vol. 30 Issue 2, p237
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Abstract: Objective: To investigate whether deep (<20°C) hypothermia is necessary in patients undergoing pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension. Methods: Between January 2004 and February 2005, 30 patients (New York Heart Association (NYHA) class III or IV) were randomly assigned to increasing (1°C) levels of moderate (28–32°C) hypothermic cardiopulmonary bypass (CPB), each study group including six patients. Primary study endpoint was adverse neurological outcome. Overall preoperative total pulmonary vascular resistance was 1110±192dynescm−5. Results: Mean CPB and cross-clamp times, and core temperature at the time of circulatory arrests were 129±39min and 92±24min, and 30.1±1.5°C, respectively. Circulatory arrest was induced 2±0.7 times and its mean total duration was 10.3±5.2min (range, 2–19min). Postoperatively, three patients (10%) belonging to the 31°C (n =1) and 32°C (n =2) groups suffered from temporary neurological dysfunction. Postoperative mechanical ventilatory support and ICU stay were 26.3±18.9h and 6.6±8.5 days, respectively, and uninfluenced by degree of hypothermia. There were no lung reperfusion injuries or any other major complications. All patients had a significant hemodynamic improvement. Conclusion: Results suggest that pulmonary endarterectomy can be safely performed with moderate hypothermia and short periods of circulatory arrests without the need of profound hypothermia.
ACCESSION #
21665217

 

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