Journal «Angiology and Vascular Surgery» • 

2013 • VOLUME 19 • №1

Dynamics of lung perfusion after pulmonary thromboendarterectomy in patients with chronic postembolic pulmonary hypertension

Chernyavsky A.M., Alyapkina E.M., Terekhov I.N., Chernyavsky M.A., Edemsky A.G.

Centre for Surgery of the Aorta, Coronary and Peripheral Arteries Federal State Facility Novosibirsk Research Institute for Circulatory Pathology named after Academician E.N. Meshalkin under the RF Ministry of Public Health and Social Development, Novosibirsk, Russia

Perfusion scintigraphy of the lungs is used as screening in order to confirm thrombormbolic genesis of pul- monary hypertension. Meanwhile, perfusion scintigraphy is a non-invasive and objective method of assessing haemocirculation in the pulmonary tissue. Using the quantitative method of calculation of the perfusion deficit, one may judge about efficiency of the treatment performed and to assess the dynamics of the state of the micro- circulatory bed of the lung. We examined a total of 53 patients presenting with chronic postembolic pulmonary hypertension, who underwent pulmonary thromboendarterectomy. Pulmonary tissue blood flow was assessed by means of perfusion scintigraphy prior to operation, and in the early postoperative (3 weeks after operation) and remote (6 months and more) periods. Analysing the values of perfusion deficit in patients depending on the pulmonary hypertension degree we revealed close correlation dependence between the perfusion deficit and pulmonary hypertension, i.e., increased pressure in the pulmonary artery was accompanied by a decreased defect of lung perfusion according to the findings of perfusion scintigraphy. Analyzing the findings of perfusion scintigraphy in patients presenting with chronic postembolic pulmonary hypertension prior to surgery, in the immediate and remote postoperative periods in all groups showed a statistically significant decrease in the perfusion deficit. It was demonstrated that the method of perfusion pulmonary scintigraphy reliably reflects the alterations in the pulmonary tissue perfusion after lung pulmonary thromboendarterectomy, thereby reflecting efficiency of surgical treatment. With the initially pronounces pulmonary hypertension, improvement of lung perfusion obtained at the hospital stage also continues in the remote period.

KEY WORDS: pulmonary thromboendarterectomy, chronic postembolic pulmonary hypertension, perfusion scintigraphy of the lungs, perfusion deficit.

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