Pulmonary thromboendarterectomy for chronic thromboembolic obstruction of the pulmonary artery in piglets Elie Fadel, MD, Jean Yves Riou, MD, Michel.

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Presentation transcript:

Pulmonary thromboendarterectomy for chronic thromboembolic obstruction of the pulmonary artery in piglets Elie Fadel, MD, Jean Yves Riou, MD, Michel Mazmanian, MD, Philippe Brenot, MD, Elisabeth Dulmet, MD, Hélène Detruit, Pharmacist, Alain Serraf, MD, Emile A. Bacha, MD, Philippe Herve, MD, Philippe Dartevelle, MD The Journal of Thoracic and Cardiovascular Surgery Volume 117, Issue 4, Pages 787-793 (April 1999) DOI: 10.1016/S0022-5223(99)70300-4 Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig 1 A typical example of selective left pulmonary angiogram. A, Before embolization. B, After embolization of multiple-curled coils and tissue adhesive in the main left pulmonary artery and the first 3 cm of the left lower lobar artery. The angiogram shows a complete obstruction of left pulmonary artery. The Journal of Thoracic and Cardiovascular Surgery 1999 117, 787-793DOI: (10.1016/S0022-5223(99)70300-4) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig 2 Surfaces of the left lungs of 2 representative piglets. One of the control group (A) and the other 5 weeks after left pulmonary artery obstruction with chronic thrombus (B). Large systemic arteries are visible on the lung surface under the visceral pleura on (B). The Journal of Thoracic and Cardiovascular Surgery 1999 117, 787-793DOI: (10.1016/S0022-5223(99)70300-4) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig 3 A typical example of pulmonary thromboendarterectomy in a piglet. The whitish chronic thrombus is adherent to the intima, and the thromboendarterectomy has to be performed through the media. Note extensions of the thrombus into the upper and the lower arteries. The Journal of Thoracic and Cardiovascular Surgery 1999 117, 787-793DOI: (10.1016/S0022-5223(99)70300-4) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig 4 Typical example of a pulmonary barium-gelatin angiogram after thromboendarterectomy shows normal patency of the left pulmonary arteries. The Journal of Thoracic and Cardiovascular Surgery 1999 117, 787-793DOI: (10.1016/S0022-5223(99)70300-4) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig 5 Cross sections of obstructed pulmonary in a piglet. Note the disruption of the intima by the thrombus, the recanalization of the thrombus by mutiluminal channels, the infiltrate of the thrombus by fibroblasts and inflammatory cells, and the hypertrophy of the vasa vasorum within the arterial wall. (Hematoxylin and eosin stain; original magnification, ×12.5.) The Journal of Thoracic and Cardiovascular Surgery 1999 117, 787-793DOI: (10.1016/S0022-5223(99)70300-4) Copyright © 1999 Mosby, Inc. Terms and Conditions