Reoperação de tromboendarterectomia pulmonar em recidiva de tromboembolismo pulmonar crônico hipertensivo

Abstract

Here, we report the case of a patient presenting CTEPH recurrence five years after the first pulmonary thromboendarterectomy and requiring reoperative thromboendarterectomy for the resolution of the symptoms. Case reportA 28-year-old female patient presented with progressive dyspnea on exertion and chest pain for two months. Se had been submitted to pulmonary thromboendarterectomy five years prior, thereafter receiving warfarin, which had been discontinued one year prior. An electro- IntroductionThromboendarterectomy has been established as the treatment of choice in the treatment of chronic thromboembolic pulmonary hypertension (CTEPH), providing, in the majority of cases, a consistent, definitive alternative for treating patients with this disease, with satisfactory shortand long-term results.(1,2) Recurrence of CTEPH after the first surgical treatment is rare, seen in 1.5% of the patients evaluated in the only case series study of such patients in the international literature. However, reoperative thromboendarterectomy in patients presenting recurrence of CTEPH has not been reported in the national literature, its safety and effectiveness therefore remaining unclear.Repeat pulmonary thromboendarterectomy after recurrence of chronic thromboembolic pulmonary hypertension* AbstractPulmonary thromboendarterectomy has been established as the standard method for the treatment of chronic thromboembolic pulmonary hypertension, with excellent results. However, repeat pulmonary thromboendarterectomy due to recurrence of pulmonary embolism has never been reported in the Brazilian literature. Its safety and effectiveness remain obscure. We report the case of a patient presenting recurrence of chronic thromboembolic pulmonary hypertension five years after the first pulmonary thromboendarterectomy and requiring a second operation for resolution of the symptoms.Keywords: Hypertension, pulmonary; Pulmonary embolism; Endarterectomy/methods. ResumoA cirurgia de tromboendarterectomia tem se estabelecido como método padrão de tratamento do tromboembolismo pulmonar crônico hipertensivo, com excelentes resultados. Entretanto, a reoperação na recidiva do embolismo pulmonar não tem relato na literatura nacional, permanecendo obscuras a sua segurança e efetividade. Relatamos o caso de uma paciente com recorrência de tromboembolismo pulmonar crônico hipertensivo ocorrido cinco anos após a primeira cirurgia de tromboendarterectomia pulmonar, e que necessitou de reoperação para resolução dos sintomas.