Echocardiographic estimation of pulmonary thrombendarterectomy (pte) long term results in patients with chronic thromboembolic pulmonary hypertension

Aim: estimation of long term surgical treatment results in patients with chronic thromboembolic pulmonary hypertension. 18 patients with chronic thromboembolic pulmonary hypertension were investigated in the remote postoperative period after pulmonary thrombendarterectomy. Average age 45.2±9.2 year. 50% male and 50% female. Echocardiography. In the remote postoperative period LV enddiastolic volume (EDV) index increase from 36.7±10.8 to 46.3±11.05 ml. LVEF (ejection fraction) is normal. RV EDS has decreased from 4.2±1.09 to 3.15±0.72 sm, the RV EDV index has decreased from 46.8±19.06 to 26.3±10.3 ml. Preoperative RV EF decreased to 44.1±6.67%, in the remote postoperative period hasnt changed. In the postoperative period diameter of tricuspid ring is reduced to 3.29±0.42 cm and tricuspid regurgitation degree decreases. In the remote postoperative period there is a restoration of LV and RV diastolic function for speed of Е peak of transmitral stream and speed of A peak of transtricuspid stream. Authentic pulmonary artery pressure decrease occured in 88.9% of patients (from 73.3±27.7 to 37.3±14.16 mm Hg). In 33.3% of patients pulmonary artery pressure has normalized. In 55.6% of patients pulmonary artery pressure increased up to a moderate pulmonary hypertension. In 2 patients (11.1%) pulmonary artery pressure remains considerably high. Pulmonary thrombendarterectomy leads to authentic pressure decrease in pulmonary artery in 88.9%. Tricuspid ring diameter reduced and its function was restored. The right heart volume decreases and it leads to tricuspid insufficiency reduction. The volume of the left ventricle increases and the diastolic function of the left ventricle restores.