AngioTAC como método de diagnóstico y decisión quirúrgica en el tromboembolismo pulmonar crónico: Discusión a propósito de un caso

Abstract

CT angiography as the diagnostic and decision making method used for surgical indication in pulmonary hypertension due to chronic thromboembolism. Report of one casePulmonary hypertension due to chronic pulmonary thromboembolism is frequently underdiagnosed and has a very poor prognosis if untreated. When the presence of central pulmonary artery thrombus is confirmed, thromboendarterectomy is the treatment of choice, with very good results. We report a 28 years old male with two previous episodes of deep venous thrombosis (DVT) who was admitted due to 8 months of progressive shortness of breath and a syncope. He underwent a CT pulmonary angiogram and an echocardiogram. Severe pulmonary hypertension was confirmed, secondary to a chronic pulmonary thromboembolism with an overlapped acute component. He received systemic thrombolysis with partial thrombus disappearance. Therefore a pulmonary thromboendarterectomy was performed and an inferior vena cava filter was placed. The patient was discharged with marked improvement in his functional capacity (Rev Méd Chile 2005; 133: 565-9). (Recibido el 24 de mayo, 2004. Aceptado en versión corregida el 8 de marzo, 2005.