What question did this study set out to answer?

To assess the efficacy, technical considerations, and patient selection criteria for thromboendarterectomy in individuals with chronic, massive thrombotic obstruction of the pulmonary arteries.

September 1, 1965Circulation

Chronic, Massive Thrombotic Obstruction of the Pulmonary Arteries

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Why the study?

Does thromboendarterectomy improve survival in patients with chronic massive pulmonary arterial thrombotic obstruction?

Population

4 patients with extensive, chronic pulmonary arterial thrombotic obstruction

Design

Case_series

Follow-up

more than 2 years

Authors

KMKenneth Μ. MoserBoston University VHVernon N. HoukCenters for Disease Control and Prevention RJRobert C. JonesStanford University

Discussion

Member takes

Implication

High perioperative mortality in advanced RV failure warrants caution; leaves open thromboendarterectomy role in chronic pulmonary arterial obstruction.

Key Points

To assess the efficacy, technical considerations, and patient selection criteria for thromboendarterectomy in individuals with chronic, massive thrombotic obstruction of the pulmonary arteries.
Case series evaluating surgical intervention in four patients (N=4) with extensive, chronic pulmonary arterial thrombotic obstruction.
Thromboendarterectomy was performed, and clinical and laboratory diagnostic strategies and candidate selection criteria were evaluated.
Thromboendarterectomy was successful in 2 of 4 patients (50%), with both individuals alive and well at more than 2 years of postoperative follow-up.
The remaining 2 of 4 patients (50%) died in the postoperative period due to advanced right ventricular failure, identifying overt cardiac decompensation as a primary surgical risk factor.

Structured PICO

Does thromboendarterectomy improve survival in patients with chronic massive pulmonary arterial thrombotic obstruction?

Population

4 patients with extensive, chronic pulmonary arterial thrombotic obstruction

Intervention

Thromboendarterectomy

Outcome

Procedural success and survivalhard clinical

Thromboendarterectomy can be a successful treatment for chronic massive pulmonary arterial occlusion, though it carries high surgical risk, particularly in patients with overt right ventricular failure.

Limitations

Small sample size
Further experience required to improve selection criteria

Cite This Study

Moser et al. (1965) studied this question.

synapsesocial.com/papers/6a87fde02d13770579f4cc22 https://doi.org/10.1161/01.cir.32.3.377

Topics

Heart failure HFrEF treatment Pulmonary embolism

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Implication

High perioperative mortality in advanced RV failure warrants caution; leaves open thromboendarterectomy role in chronic pulmonary arterial obstruction.

Chronic, Massive Thrombotic Obstruction of the Pulmonary Arteries

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Topics

Chronic, Massive Thrombotic Obstruction of the Pulmonary Arteries

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Also Consider

Topics

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