Surgical Treatment of Chronic Pulmonary Thromboembolism (c-PTE) and the Trial to make an animal model of c-PTE with beagle

(1)临床研究：c-PTE患者的手术治疗效果。本院共收治25例c-PTE患者。术后30天死亡4例。死亡率为16.0%。但其他病人明显好转。术后室内空气中动脉血气、心脏指数、平均肺动脉压和肺血管阻力均有改善。18例患者术后NYHA分级优于术前。它们在NYHA 1或2.2中。肺动脉手术入路的选择。我们有两种入路到达肺动脉，经正中入路和经外侧开胸入路。我们探讨经正中入路与经外侧开胸入路术后疗效的差异。术中肺动脉标本的病理研究。我们发现试样的性质可分为两种，一种是坚固，另一种是脆弱。这一特性对手术入路的选择具有重要意义。我们使用了血管内光纤镜。在c-PTE患者血栓栓塞后，确认远端肺动脉回流是非常有用的。(2) beagle造c-PTE动物模型试验：给狗注射氨甲环酸，在狗下腔静脉形成血栓，吹至肺动脉。所以我们尝试做一个c-PTE的模型。但我们做不到。这很难。我们选择了新的方法来制作它。现在增田医生住在美国圣地亚哥，他正在向加州大学圣地亚哥分校的肺病医务人员学习。（总结）c-PTE的手术治疗是非常有用的。术后患者的生活质量（QOL）优于术前。但我们并不满足于此。c-PTE的实验对更好地了解疾病非常重要，因此我们希望制作c-PTE的动物模型。少

(1)Clinical Investigation :1.Result of surgical treatment for c-PTE patients. 25 patients of c-PTE were surgically treated in our hospital. 4 patients were dead during postoperative 30 days. The mortarity is 16.0%. But the other patients were obviously improved. The arterial blood gas in room air, cardiac index, mean-pulmonary arterial pressure and pulmonary vascular resistance are improved after operaton. The NYHA classifications of postoperative days are better than that of preoperative in 18 patients. They are in the NYHA 1 or 2.2.Selection of Surgical approach to pulmonary artery. We have two ways of approach to arrive at pulmonary artery, Through Median Approach and Through Lateral Thoracotomy Approach. We investigate the difference of postoperative results through median approach from through lateral thoracotomy approach.3.Pathological study of the specimen from patients'pulmonary artery during operation. We find that the specimens is classified into two kinds of character, firm … More and fragile. This character is very important for selective of approach during operation.4.We used the intravascular optical fiber scope. It is very useful to confirm back flow from distal pulmonary artery after thromboembolecty in c-PTE patients.(2)Trial to make an animal model of c-PTE with beagle :We give the Tranexamic acid to dogs, make thrombus in inferior vena cava of the dogs, and blow off it to pulmonary artery. So that we try to make a model of c-PTE.But we can't make that model. It is very difficult. We choose new method to make it. Now Dr.Masuda is staying at San Diego in U.S.A.and he is learning it from the pulmonary medical staff of the University of California, San Diego.(Summary) The surgical treatment of c-PTE is very useful. The quolity of life (QOL) of postoperative patients is better than that of preoperative. But we are not satisfied with that. The experiment of c-PTE is very important to understand the disease better, so that we want to make an animal model of c-PTE. Less