Pulmonary Endarterectomy for Chronic Thromboembolic Pulmonary Hypertension Secondary to Expanded Polytetrafluoroethylene Valved Pulmonary Conduit Thrombosis

Figures

• 

  Figure 1. Diagnostic Evaluation for Chronic Thromboembolic Pulmonary Hypertension (A) Quantitative lung perfusion scintigraphy demonstrating asymmetrical perfusion with 11% to the left lung and 89% to the right lung. (B) Computed tomography pulmonary angiogram demonstrating bilateral thromboembolic disease (arrow) and dilation of the proximal right pulmonary artery (20.0 × 22.8 mm). (C) Pulmonary artery catheterization and angiogram with mean pulmonary artery pressure (21 mm Hg) and pulmonary vascular resistance (2.3 WU).

• 

  Figure 2. Pulmonary Endarterectomy and ePTFE Conduit Specimen (A) Endarterectomy specimen with thickened intima and fibrous webs and bands as well as evidence of more acute thromboembolic disease (arrow). (B) En-bloc ePTFE conduit with pathologically confirmed organized thrombus at the site of distal anastomosis. ePTFE = expanded polytetrafluoroethylene.

• 

  Figure 3. Pulmonary Artery Catheterization and Angiogram 3 Months Postprocedure The study demonstrated improved pulmonary vascular resistance (0.89 WU).