Azarian R, Brenot F, Sitbon O, Parent F, Petitpretz P, Musset D, Grimon G, Dartevelle P, Simonneau G, Duroux P
Service de pneumologie, hôpital Antoine-Béclère, Clamart.
Arch Mal Coeur Vaiss. 1994 Dec;87(12):1709-13.
Chronic thromboembolic pulmonary hypertension is a rare complication of acute pulmonary embolism. The therapeutic approach to the disease is addressed, based on a series of 81 patients referred to our department between 1984 and 1993. Medical treatment associates long-term anticoagulant therapy and, in some cases, inferior vena cava interruption. Two surgical procedures are available in selected patients: lung transplantation and pulmonary thrombo-endareterectomy. Lung transplantation has been performed in 8 patients since 1988 with 6 survivors with a maximal follow-up of 5 years. Twelve patients underwent pulmonary thromboendareterectomy with in 9 patients a dramatic functional and haemodynamic improvement. Chronic thromboembolism should be systematically investigated as the cause of pulmonary hypertension considering that in selected cases, curative surgery is possible.
慢性血栓栓塞性肺动脉高压是急性肺栓塞的一种罕见并发症。本文基于1984年至1993年间转诊至我科的81例患者，探讨了该疾病的治疗方法。药物治疗包括长期抗凝治疗，在某些情况下还包括下腔静脉阻断。对于部分选定患者有两种外科手术可供选择：肺移植和肺动脉血栓内膜剥脱术。自1988年以来，已有8例患者接受了肺移植，其中6例存活，最长随访时间为5年。12例患者接受了肺动脉血栓内膜剥脱术，其中9例患者的功能和血流动力学有显著改善。鉴于在某些选定病例中可以进行根治性手术，对于肺动脉高压的病因应系统地调查慢性血栓栓塞情况。
