Ali Vefa ÖZCAN, Ahmet BALTALARLI, Hülya SUNGURTEKİN, Şeyda Örs KAYA, İbrahim GÖKŞİN, Gökhan ÖNEM, Mustafa SAÇAR

Pulmoner Tromboendarterektomi Olgusu

Kronik tromboembolik pulmoner hipertansiyonlu hastalarda kardiyopulmoner fonksiyonlar pulmoner tromboendarterektomi ile normale döndürülebilir. Pulmoner tromboendarterektomi (PTE); kardiyopulmoner baypas eşliğinde, pulmoner arterlerden organize olmuş fibröz materyallerin çıkartılmasını temel alan, mortalitesi yüksek cerrahi bir işlemdir. Bu yazıda; 6 yıl önce geçirmiş olduğu derin ven trombozuna bağlı kronik tromboembolik pulmoner hipertansiyon gelişen, 28 yaşında bir erkek hastaya yaptığımız PTE olgusunu sunmayı amaçladık. Olguda öncelikle cerrahi mortalitenin yüksek olması nedeniyle doku plazminojen aktivatörü kullanıldı. Klinik durumun düzelmemesi üzerine PTE uygulandı. Pompa sonrası ve erken operasyon sonrası dönemde bütün veriler normale döndü. Ancak ameliyat sonrası 4.saatte pulmoner ödem tablosu gelişmesi ve ilave tedaviler ile klinik bulguların düzelmemesi üzerine operasyon sonrası 12. saatte ani gelişen kardiyak arrest nedeniyle hasta kaybedildi. Bu tür cerrahi girişimler ile elde edilecek klinik deneyimlerin cerrahi mortaliteyi zamanla azaltacağını düşünüyoruz.©2008, Fırat Üniversitesi, Tıp Fakültesi

Anahtar Kelimeler:

Pulmoner hipertansiyon, tromboendarterektomi

A Case of Pulmonary Thromboendarterectomy

Cardiopulmonary function in patients with chronic thromboembolic pulmonary hypertension can be normalized by pulmonary endarterectomy. Pulmonary thromboendarterectomy (PTE) is likely that organized fibrous materials have taken out with during cardiopulmonary bypass. It has high mortality. We aimed to present a case of pulmonary endarterectomy following chronic thromboembolic pulmonary hypertension due to deep venous thrombosis before 6 years ago, who is 28 years old-male, in this paper. First, a tissue-plasminogen activator was used because of high surgical mortality. As clinic situation did not relieve, PTE was performed in the patient. All data improved in early postoperative period and after pump. Nevertheless the state of pulmonary edema progressed in the 4th hour of postoperative period approximately. Although additional medical treatment, the clinical situation of patient impaired again in the 12th hour of postoperative period. The patient was expired due to cardiac arrest. We think that surgical mortality will be decreased by obtained clinical experience with such surgical interventions. ©2008, Firat University, Medical Faculty

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Kabul Tarihi: 30.05.2007