Tedoriya T, Kawasuji M, Sawa S, Kawakami K, Iwa T, Matsushita S
Kyobu Geka. 1989 Dec;42(13):1131-4.
Chronic pulmonary embolism is resistant to medicinal treatment. This is a report of the successful operation for chronic pulmonary embolism. A 29-year-old man suffered from dyspnea attack twice half a year in spite of intensive anticoagulant therapy. Cardiac catheterization showed pulmonary hypertension of 72/25 mmHg, mean 42 mmHg. Pulmonary angiogram demonstrated emboli in the right pulmonary artery and pulmonary perfusion scintigram revealed large perfusion defect in the right lung. The patient underwent pulmonary embolectomy after the total cardiopulmonary bypass. After surgery, blood gas showed an increased PaO2 from 65 to 77 mmHg. Pulmonary artery pressure decreased to 39/12 mmHg, mean 23 mmHg. Pulmonary arteriogram showed increased pulmonary vascular beds and pulmonary scintigram showed an increased perfusion in the right lung. The patient has been free from symptom and a half year after surgery.
慢性肺栓塞对药物治疗耐药。本文报告一例慢性肺栓塞手术成功的病例。一名29岁男性尽管接受了强化抗凝治疗，但半年内仍发作两次呼吸困难。心导管检查显示肺动脉高压为72/25 mmHg，平均42 mmHg。肺血管造影显示右肺动脉有栓子，肺灌注闪烁扫描显示右肺有大面积灌注缺损。患者在全心肺转流后接受了肺动脉栓子切除术。术后血气分析显示动脉血氧分压（PaO2）从65 mmHg升至77 mmHg。肺动脉压降至39/12 mmHg，平均23 mmHg。肺动脉造影显示肺血管床增加，肺闪烁扫描显示右肺灌注增加。患者术后半年无症状。
