Document Detail

KMA-Greenfield filter placement for chronic pulmonary hypertension.
MedLine Citation:
PMID:  443909     Owner:  NLM     Status:  MEDLINE    
Over a period of four years, 23 patients had the diagnosis of chronic pulmonary hypertension made on the basis of elevated resting pulmonary arterial pressures above 30 mmHg mean. Clinical features included dyspnea (100%), previous thromboembolism (43%), congestive failure (39%), venous thrombosis (35%), syncope (30%), lung disease (22%), recent trauma (22%), hemoptysis (17%) and precordial pain (17%). Pulmonary angiograms showed embolic occlusion in all but four patients, who were considered to have primary pulmonary hypertension. KimRay-Greenfield((R)) vena caval filters were inserted in 18 patients. Three of them were in refractory shock at the time, and only the one who had successful intraluminal catheter embolectomy survived. These patients have been followed an average of 23 months with two embolic deaths, one from the right atrium and one bypassing a filter misplaced in the right iliac vein (overall mortality 22%). There has been no other known recurrent embolism, but one patient developed hematuria from the filter. The five patients who did not receive a filter have all died after intervals up to 18 months. Recurrent thromboembolism was documented in three and suspected in one patient with known embolic disease who died suddenly. Regardless of etiologic factors, pulmonary hypertension with cor pulmonale is associated with a high incidence of fatal thromboembolism. In our experience, maximal protection is afforded by long-term anticoagulation therapy and the placement of a venacaval filter.
L J Greenfield; L A Scher; R C Elkins
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of surgery     Volume:  189     ISSN:  0003-4932     ISO Abbreviation:  Ann. Surg.     Publication Date:  1979 May 
Date Detail:
Created Date:  1979-07-28     Completed Date:  1979-07-28     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  560-5     Citation Subset:  AIM; IM    
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MeSH Terms
Chronic Disease
Filtration / instrumentation*
Follow-Up Studies
Hypertension, Pulmonary / etiology,  mortality,  therapy*
Middle Aged
Thromboembolism / complications,  prevention & control
Venae Cavae

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