Inhaled iloprost in patients with chronic thromboembolic pulmonary hypertension: effects before and after pulmonary thromboendarterectomy Thorsten Kramm,

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Presentation transcript:

Inhaled iloprost in patients with chronic thromboembolic pulmonary hypertension: effects before and after pulmonary thromboendarterectomy Thorsten Kramm, MD, Balthasar Eberle, MD, Frank Krummenauer, PhD, Stefan Guth, MD, Hellmut Oelert, MD, Eckhard Mayer, MD The Annals of Thoracic Surgery Volume 76, Issue 3, Pages 711-718 (September 2003) DOI: 10.1016/S0003-4975(03)00728-8

Fig 1 Preoperative and postoperative changes of (A) cardiac index (CI), (B) mean pulmonary artery pressure (mPAP), and (C) mean systemic pressure (mAP) during and after normal saline (NaCl) (not significant) followed by iloprost (Ilo) inhalation. (ICU = intensive care unit.) The Annals of Thoracic Surgery 2003 76, 711-718DOI: (10.1016/S0003-4975(03)00728-8)

Fig 2 (A) Preoperative and (B, C) postoperative time courses of systemic (▴) and pulmonary vascular resistance (■) during iloprost inhalation. (B) ICU admission. (C) 12 h postoperatively. (ICU = intensive care unit; PVR = pulmonary vascular resistance; SVR = systemic vascular resistance.) ▴ = SVR/dynes · s · cm−5; ■ = PVR/dynes · s · cm−5. The Annals of Thoracic Surgery 2003 76, 711-718DOI: (10.1016/S0003-4975(03)00728-8)

Fig 3 Calculated PVR/SVR ratio during iloprost inhalation at (A) T1, (B) T2, and (C) T3. (A) Increase of ratio demonstrating overwhelming systemic side effects with premature abort of measurements (50 minutes), *p less than 0.05 versus ILO-start. (B, C) Significant decrease of ratio indicating predominant pulmonary vasodilatation, *p less than 0.05, §p less than 0.01 versus ILO-start. (ILO = iloprost; PVR = pulmonary vascular resistance; SVR = systemic vascular resistance.) The Annals of Thoracic Surgery 2003 76, 711-718DOI: (10.1016/S0003-4975(03)00728-8)

Fig 3 Calculated PVR/SVR ratio during iloprost inhalation at (A) T1, (B) T2, and (C) T3. (A) Increase of ratio demonstrating overwhelming systemic side effects with premature abort of measurements (50 minutes), *p less than 0.05 versus ILO-start. (B, C) Significant decrease of ratio indicating predominant pulmonary vasodilatation, *p less than 0.05, §p less than 0.01 versus ILO-start. (ILO = iloprost; PVR = pulmonary vascular resistance; SVR = systemic vascular resistance.) The Annals of Thoracic Surgery 2003 76, 711-718DOI: (10.1016/S0003-4975(03)00728-8)