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Chronic thromboembolic pulmonary hypertension: surgical treatment with thromboendarterectomy
Hipertensión pulmonar tromboembólica crónica: tratamiento mediante tromboendarterectomía quirúrgica
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"paginaFinal" => "501" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "José Antonio Blázquez, Pilar Escribano, Enrique Pérez, María Jesús López, Miguel Ángel Gómez, José María Cortina" "autores" => array:6 [ 0 => array:4 [ "nombre" => "José Antonio" "apellidos" => "Blázquez" "email" => array:1 [ 0 => "blazquezmd@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "Pilar" "apellidos" => "Escribano" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 2 => array:3 [ "nombre" => "Enrique" "apellidos" => "Pérez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 3 => array:3 [ "nombre" => "María Jesús" 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"identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hipertensión pulmonar tromboembólica crónica: tratamiento mediante tromboendarterectomía quirúrgica" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2009-01-21" "fechaAceptado" => "2009-05-28" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec155474" "palabras" => array:3 [ 0 => "Chronic thromboembolic pulmonary hypertension" 1 => "Pulmonary thromboendarterectomy" 2 => "Pulmonary thromboembolism" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec155473" "palabras" => array:3 [ 0 => "Hipertensión pulmonar tromboembólica crónica" 1 => "Tromboendarterectomía pulmonar" 2 => "Tromboembolia pulmonar" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Background and objectives</span><p class="elsevierStyleSimplePara elsevierViewall">Pulmonary thromboendarterectomy (PTE) is considered the potential curative treatment for chronic thromboembolic pulmonary hypertension (CTEPH). We analysed the results of the PTE application in our institution.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">From February 1996 to December 2007, 30 patients with CTEPH underwent videoassisted PTE. Preoperative hemodynamic data were: systolic pulmonary artery pressure (SPAP) 87±17 mmHg, mean pulmonary artery pressure (MPAP) 51±11 mmHg, pulmonary total resistance 1067±485 dynes·s·cm<span class="elsevierStyleSup">−5</span>, pulmonary vascular resistance 873±389 dynes·s·cm<span class="elsevierStyleSup">−5</span> and cardiac index 2.2±0.5 l/min/m<span class="elsevierStyleSup">2</span>. We analysed the influence of several factors on hospital mortality and survival, and we performed partial analysis of mortality since 2004.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">PTE resulted in significant improvements in SPAP (<span class="elsevierStyleItalic">P</span><0.001), MPAP (<span class="elsevierStyleItalic">P</span>=0.001) and cardiac index (<span class="elsevierStyleItalic">P</span><0.001). Hospital mortality was 17% (5/30) (95% confidence interval, 6%-35%). From 2004, it dropped to 5% (1/20) (95% confidence interval, 0%-25%). Hospital mortality was influenced by preoperative pulmonary total resistance, preoperative pulmonary vascular resistance, postoperative SPAP, reduction of SPAP, reduction of MPAP, reperfusion pulmonary oedema and residual postoperative pulmonary hypertension (<span class="elsevierStyleItalic">P</span>=0.036; <span class="elsevierStyleItalic">P</span>=0.018;<span class="elsevierStyleItalic">P</span>=0.013; <span class="elsevierStyleItalic">P</span>=0.050; <span class="elsevierStyleItalic">P</span>=0.050; <span class="elsevierStyleItalic">P</span>=0.030; <span class="elsevierStyleItalic">P</span>=0.045). Survival after PTE, including hospital mortality, was 76±9% at 10 years. Through long-term follow-up, functional status (<span class="elsevierStyleItalic">P</span>=0.001), 6 min walking distance (<span class="elsevierStyleItalic">P</span>=0.001), end-diastolic right ventricle size (<span class="elsevierStyleItalic">P</span><0.001), and tricuspid regurgitation (<span class="elsevierStyleItalic">P</span><0.001) significantly improved.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">PTE effectively reduces pulmonary hypertension and offers CTEPH patients a substantial improvement in survival and quality of life.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Introducción</span><p class="elsevierStyleSimplePara elsevierViewall">La tromboendarterectomía pulmonar (TP) constituye el tratamiento potencialmente curativo de la hipertensión pulmonar tromboembólica crónica (HTPTC). Analizamos los resultados de la aplicación de la TP en nuestra institución.</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Entre febrero de 1996 y diciembre de 2007 se realizó TP videoasistida a 30 pacientes con HTPTC. Los datos hemodinámicos preoperatorios fueron (valores medios±desviación estándar): presión sistólica pulmonar (PSP), 87±17 mmHg; presión arterial pulmonar media (PAPm), 51 ± 11 mmHg; resistencia pulmonar total, 1.067 ± 485 dinas·s·cm<span class="elsevierStyleSup">−5</span>; resistencia vascular pulmonar, 873 ± 389 dinas·s·cm<span class="elsevierStyleSup">−5</span>, e índice cardíaco, 2,2 ± 0,5 l/min/m<span class="elsevierStyleSup">2</span>. Se han analizado los factores que influyeron en la mortalidad hospitalaria y la supervivencia, además de realizarse un análisis parcial de la mortalidad a partir de 2004.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Tras la TP se objetivó un descenso tanto de la PSP (p < 0,001) como de la PAPm (P = 0,001) y un aumento del índice cardíaco (p < 0,001). La mortalidad hospitalaria registrada fue del 17% (5/30; intervalo de confianza del 95%, 6–35%); a partir de 2004 se redujo al 5% (1/20; intervalo de confianza del 95%, 0–25%). La resistencia pulmonar total y la resistencia vascular pulmonar preoperatorias, la PSP postoperatoria, el descenso porcentual de la PSP y de la PAPm, la presencia de edema de reperfusión y la persistencia de la HTP evidenciaron asociación con la mortalidad hospitalaria (p = 0,036; p = 0,018; p = 0,013; p = 0,050; p = 0,050; p = 0,030; p = 0,045, respectivamente). La supervivencia actuarial a 10 años, incluyendo la mortalidad hospitalaria, fue del 76 ± 9%. Durante el seguimiento mejoró la clase funcional (p = 0,001), aumentó la distancia recorrida en la prueba de la marcha de 6 min (p = 0,001) y se redujeron tanto el diámetro telediastólico del ventrículo derecho (p < 0,001) como el grado de regurgitación tricuspídea (p < 0,001).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La TP mejora la hemodinámica pulmonar, prolonga la supervivencia y optimiza el estado funcional de pacientes con HTPTC.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:30 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 5 | 5 | 10 |
| 2024 October | 31 | 25 | 56 |
| 2024 September | 23 | 16 | 39 |
| 2024 August | 44 | 29 | 73 |
| 2024 July | 25 | 18 | 43 |
| 2024 June | 29 | 30 | 59 |
| 2024 May | 46 | 33 | 79 |
| 2024 April | 14 | 27 | 41 |
| 2024 March | 19 | 14 | 33 |
| 2024 February | 21 | 24 | 45 |
| 2023 March | 3 | 1 | 4 |
| 2023 February | 15 | 26 | 41 |
| 2023 January | 20 | 30 | 50 |
| 2022 December | 22 | 24 | 46 |
| 2022 November | 19 | 23 | 42 |
| 2022 October | 20 | 35 | 55 |
| 2022 September | 19 | 27 | 46 |
| 2022 August | 21 | 45 | 66 |
| 2022 July | 17 | 46 | 63 |
| 2022 June | 16 | 45 | 61 |
| 2022 May | 20 | 40 | 60 |
| 2022 April | 17 | 31 | 48 |
| 2022 March | 23 | 46 | 69 |
| 2022 February | 20 | 35 | 55 |
| 2022 January | 12 | 38 | 50 |
| 2021 December | 21 | 48 | 69 |
| 2021 November | 17 | 48 | 65 |
| 2021 October | 15 | 58 | 73 |
| 2021 September | 16 | 58 | 74 |
| 2021 August | 8 | 44 | 52 |
| 2021 July | 12 | 37 | 49 |
| 2021 June | 14 | 36 | 50 |
| 2021 May | 12 | 28 | 40 |
| 2021 April | 34 | 89 | 123 |
| 2021 March | 27 | 13 | 40 |
| 2021 February | 12 | 18 | 30 |
| 2021 January | 15 | 13 | 28 |
| 2020 December | 11 | 19 | 30 |
| 2020 November | 6 | 7 | 13 |
| 2020 October | 12 | 14 | 26 |
| 2020 September | 11 | 2 | 13 |
| 2020 August | 10 | 7 | 17 |
| 2020 July | 11 | 11 | 22 |
| 2020 June | 10 | 7 | 17 |
| 2020 May | 14 | 14 | 28 |
| 2020 April | 12 | 13 | 25 |
| 2020 March | 7 | 9 | 16 |
| 2020 February | 18 | 16 | 34 |
| 2020 January | 16 | 16 | 32 |
| 2019 December | 19 | 12 | 31 |
| 2019 November | 12 | 11 | 23 |
| 2019 October | 25 | 5 | 30 |
| 2019 September | 8 | 15 | 23 |
| 2019 August | 16 | 9 | 25 |
| 2019 July | 7 | 19 | 26 |
| 2019 June | 6 | 6 | 12 |
| 2019 May | 10 | 8 | 18 |
| 2019 April | 13 | 13 | 26 |
| 2019 March | 13 | 17 | 30 |
| 2019 February | 11 | 8 | 19 |
| 2019 January | 15 | 6 | 21 |
| 2018 December | 10 | 13 | 23 |
| 2018 November | 16 | 20 | 36 |
| 2018 October | 23 | 24 | 47 |
| 2018 September | 10 | 9 | 19 |
| 2018 May | 12 | 0 | 12 |
| 2018 April | 9 | 3 | 12 |
| 2018 March | 5 | 5 | 10 |
| 2018 February | 7 | 8 | 15 |
| 2018 January | 5 | 6 | 11 |
| 2017 December | 8 | 5 | 13 |
| 2017 November | 4 | 7 | 11 |
| 2017 October | 6 | 7 | 13 |
| 2017 September | 4 | 6 | 10 |
| 2017 August | 12 | 12 | 24 |
| 2017 July | 18 | 13 | 31 |
| 2017 June | 12 | 15 | 27 |
| 2017 May | 5 | 5 | 10 |
| 2017 April | 4 | 5 | 9 |
| 2017 March | 2 | 3 | 5 |
| 2017 February | 5 | 7 | 12 |
| 2017 January | 3 | 3 | 6 |
| 2016 December | 11 | 7 | 18 |
| 2016 November | 13 | 6 | 19 |
| 2016 October | 9 | 4 | 13 |
| 2016 September | 10 | 10 | 20 |
| 2016 August | 10 | 7 | 17 |
| 2016 July | 15 | 7 | 22 |
| 2016 May | 1 | 0 | 1 |
| 2016 March | 7 | 0 | 7 |
| 2016 February | 6 | 0 | 6 |
| 2016 January | 6 | 0 | 6 |
| 2015 December | 3 | 0 | 3 |
| 2015 October | 69 | 6 | 75 |
| 2015 September | 61 | 11 | 72 |
| 2015 August | 61 | 9 | 70 |
| 2015 July | 71 | 6 | 77 |
| 2015 June | 47 | 3 | 50 |
| 2015 May | 43 | 18 | 61 |
| 2015 April | 44 | 13 | 57 |
| 2015 March | 32 | 6 | 38 |
| 2015 February | 43 | 3 | 46 |
| 2015 January | 48 | 5 | 53 |
| 2014 December | 51 | 5 | 56 |
| 2014 November | 32 | 8 | 40 |
| 2014 October | 56 | 8 | 64 |
| 2014 September | 43 | 7 | 50 |
| 2014 August | 48 | 13 | 61 |
| 2014 July | 40 | 13 | 53 |
| 2014 June | 64 | 9 | 73 |
| 2014 May | 62 | 12 | 74 |
| 2014 April | 64 | 20 | 84 |
| 2014 March | 57 | 7 | 64 |
| 2014 February | 57 | 7 | 64 |
| 2014 January | 45 | 11 | 56 |
| 2013 December | 53 | 9 | 62 |
| 2013 November | 48 | 4 | 52 |
| 2013 October | 48 | 10 | 58 |
| 2013 September | 60 | 9 | 69 |
| 2013 August | 48 | 7 | 55 |
| 2013 July | 91 | 12 | 103 |
| 2013 June | 85 | 8 | 93 |
| 2013 May | 54 | 6 | 60 |
| 2013 April | 11 | 4 | 15 |
| 2013 March | 6 | 3 | 9 |
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