Daghero Fernando J, Casas Juan P, Sarmiento Pablo E, Colque Roberto M A, Tibaldi Miguel A, Moreyra Eduardo, Martínez Riera Leandro, Pacheco Guillermo
Servicio de Cardiología, Sanatorio Allende, Córdoba, Argentina. E-mail:
Servicio de Neumonología, Sanatorio Allende, Córdoba, Argentina.
Medicina (B Aires). 2018;78(6):453-457.
Chronic thromboembolic pulmonary hypertension is characterized by the presence of organized thrombotic material in the pulmonary arteries which causes elevation of the pulmonary vascular resistance, right heart failure, and death if not treated. Pulmonary thromboendarterectomy is the treatment of choice and can be curative when the obstruction is proximal. There are cases in which this therapy is not possible, and pulmonary angioplasty is a therapeutic alternative of growing interest. We present our experience with three patients diagnosed with chronic thromboembolic pulmonary hypertension in whom pulmonary endarterectomy was not possible and pulmonary angioplasty was performed. All patients showed improvement of functional class, six-minute walk distance, and hemodynamic as well as angiographic parameters.
慢性血栓栓塞性肺动脉高压的特征是肺动脉中存在机化的血栓物质，这会导致肺血管阻力升高、右心衰竭，若不治疗则会导致死亡。肺动脉血栓内膜剥脱术是首选治疗方法，当阻塞位于近端时可治愈。在某些情况下无法进行这种治疗，而肺血管成形术是一种越来越受关注的治疗选择。我们介绍了3例诊断为慢性血栓栓塞性肺动脉高压患者的治疗经验，这些患者无法进行肺动脉内膜剥脱术，而行肺血管成形术。所有患者的功能分级、6分钟步行距离、血流动力学及血管造影参数均有改善。
