1 4 5 In our institution, experience with more than 200 patients indicates that pulmonary angiography can be safely performed even in patients with severe chronic thromboembolic pulmonary hypertension. Pulmonary angiography is still the gold standard to establish the diagnosis preoperatively because its characteristic abnormalities such as webs and bands, pouchlike endings of arteries, irregularities of the arterial wall, and unusual stenotic lesions are best seen angiographically. Oxygen contributes to safety during the procedure.īecause chronic major-vessel thromboembolic pulmonary hypertension is curable by pulmonary thrombendarterectomy, 1 2 3 the diagnostic procedure becomes more important. Systemic pressure therefore decreased in group 3.Ĭonclusions We concluded that bolus injection of nonionic contrast medium causes no major hemodynamic effects even in patients with severe chronic thromboembolic pulmonary hypertension. Cardiac index increased in groups 1 and 2 but was unchanged in group 3. Systemic vascular resistance was decreased. After the angiography, pulmonary artery pressure was moderately increased, predominantly in group 3, but pulmonary vascular resistance was not significantly changed. Contrast bolus injection caused only a minor pressure increase (ΔPA systolic, 2.3☑.4, 2.5☑.8, and 5.0±5.2 mm Hg, groups 1, 2, and 3, respectively) without significance between the groups. Before contrast bolus injection, RAP and PAP significantly increased because of initial inspiration. One hundred ninety-eight angiograms were performed selectively on both pulmonary arteries in the posterior-anterior, oblique, and lateral views. Pulmonary artery pressure and heart rate were reduced, but pulmonary vascular resistance and total pulmonary resistance were not significantly affected. Oxygen inhalation significantly improved oxygen supply. Methods and Results In 33 patients, hemodynamic parameters were measured after oxygen inhalation and during bolus injection of nonionic contrast medium in a control group (group 1, n=11), in a group of patients with moderately severe pulmonary hypertension (group 2, n=9), and in a group with severe pulmonary hypertension (group 3, n=13). This study evaluates the hemodynamic effects of direct pulmonary nonionic contrast bolus injection and oxygen inhalation in patients with chronic thromboembolic pulmonary hypertension. Customer Service and Ordering Informationīackground Pulmonary angiography is the gold standard for the diagnosis of chronic thromboembolic pulmonary hypertension however, major complications have been reported.Stroke: Vascular and Interventional Neurology.Journal of the American Heart Association (JAHA).
Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB).
0 kommentar(er)
