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Pulmonary Endarterectomy: Part II. Operation, Anesthetic Management, and Postoperative Care.
[heparin-induced thrombocytopenia]
Chronic
thromboembolic
pulmonary
hypertension
(
CTEPH
)
results
from
recurrent
or
incomplete
resolution
of
pulmonary
embolism
.
CTEPH
is
much
more
common
than
generally
appreciated
.
Although
pulmonary
embolism
(
PE
)
affects
a
large
number
of
Americans
,
chronic
pulmonary
thromboembolic
hypertension
remains
underdiagnosed
.
It
is
imperative
that
all
patients
with
pulmonary
hypertension
(
PH
)
be
screened
for
the
presence
of
CTEPH
since
this
form
of
PH
is
potentially
curable
with
pulmonary
endarterectomy
(
PEA
)
surgery
.
The
success
of
this
procedure
depends
greatly
on
the
collaboration
of
a
multidisciplinary
team
approach
that
includes
pulmonary
medicine
,
cardiothoracic
surgery
,
and
cardiac
anesthesiology
.
This
review
,
based
on
the
experience
of
more
than
3000
pulmonary
endarterectomy
surgeries
,
is
divided
into
2
parts
.
Part
I
focuses
on
the
clinical
history
and
pathophysiology
,
diagnostic
workup
,
and
intraoperative
echocardiography
.
Part
II
focuses
on
the
surgical
approach
,
anesthetic
management
,
postoperative
care
,
and
complications
.
Diseases
Validation
Diseases presenting
"pulmonary embolism"
symptom
acute rheumatic fever
allergic bronchopulmonary aspergillosis
heparin-induced thrombocytopenia
homocystinuria without methylmalonic aciduria
locked-in syndrome
proteus syndrome
pyomyositis
thoracic outlet syndrome
This symptom has already been validated