Proceedings of the American Thoracic Society
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Cardiopulmonary function in patients with chronic thromboembolic pulmonary hypertension can almost be normalized by pulmonary endarterectomy. The procedure involves the removal of organized and incorporated fibrous obstructive tissue from the pulmonary arteries during circulatory arrest under deep hypothermia. Mortality rates reported for patients who have undergone pulmonary endarterectomy range from 4 to 24%. ⋯ Important complications are persistent pulmonary arterial hypertension due to inadequate endarterectomy or significant secondary vasculopathy, and reperfusion edema in the endarterectomized parts of the lung. Adequate postoperative care is therefore essential. Preoperative hemodynamic severity and the site of anatomic obstruction are believed to be key predictors of postoperative outcome.