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Ann Thorac Surg 1996;62:1253-1254
© 1996 The Society of Thoracic Surgeons

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Editorial

Thromboendarterectomy: Some Unanswered Questions

Department of Medicine, Washington University School of Medicine, St. Louis, Missouri

The first 20% of the full text of this article appears below.

Recognition of chronic organized thromboemboli as a cause of sustained pulmonary hypertension and the development of a surgical approach to the disease have been major steps in establishing chronic thromboembolic pulmonary hypertension as one of the few potentially curable causes of pulmonary hypertension [1–3]. Increasing experience with this disease at a number of centers now indicates that we can successfully treat many of these patients by thromboendarterectomy after selection by appropriate diagnostic evaluations. As with most diseases, we still have many unanswered questions, some of which have emerged from our ability to remove the obstructing material. The article in this issue by Hartz and colleagues [4] suggests some of these important questions.

We do not know why the vast majority of patients presenting with this problem do not have normal resolution of their acute thrombotic obstruction. Only a minority have identifiable procoagulant tendencies, most commonly the presence of antiphospholipid antibodies. The remainder have no known risk factors and are the subject of active investigation, although studies to date have not identified defects in blood vessel-related lytic mechanisms [5].

See . . . [Full Text of this Article]

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Predictors of Mortality in Pulmonary Thromboendarterectomy

Renee S. Hartz, John G. Byrne, Sidney Levitsky, John Park, and Stuart Rich
Ann. Thorac. Surg. 1996 62: 1255-1259. [Abstract] [Full Text]

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