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The CTEPH Diagnosis and Treatment Team Saves the 50th Patient of Pulmonary Hypertension
Source:Publicity Office Posted Date:09-05-2019

From 9:00 a.m. to 18:00 p.m. on August 27, 2019, a 9-hour thrilling operation was performed. The 50th case of pulmonary thromboendarterectomy(PTE)performed by the diagnosis and treatment team of the China-Japan Friendship Hospital for chronic thromboembolic pulmonary hypertension (hereinafter referred to as CTEPH) was successfully completed, and the patient was transferred to the surgical ICU smoothly. The patient and his family, who had been suffering from chronic thrombosis and pulmonary hypertension for years, were reborn. The data on the monitor today show that the patient's pulmonary artery pressure has dropped to a normal level.
 
At 8 a.m. on August 27, Party Secretary Zhou Jun, President Sun Yang and heads of administrative divisions came to the operating room and attended the summary meeting on the 50th case of PTE. Meanwhile, on behalf of the hospital, they visited the doctors and nurses in the CTEPH team and sent flowers and cakes to them. Heads and head nurses of the Department of Cardiac Surgery, Department of Anesthesiology, Department of Respiratory and Critical Care Medicine, Department of Surgical Critical Medicine, and Department of Radiology of our CTEPH team participated in the event and made speeches.
 
Dr. Sun Yang thanked the team for saving the patient with exquisite and difficult surgery. He called on the clinical departments of the whole hospital to learn from the CTEPH team and relieve the pain for the patients.
 
Mr. Zhou Jun expressed his gratitude to the team for its hard work. At the same time, he made several requests: First, the CTEPH diagnosis and treatment team should be well established, and the development plan should be made from disciplines, management, and talents to create a superior discipline. Second, chronic patients with thromboembolic pulmonary hypertension are very painful with poor quality of life and a heavy burden. As a hospital under the direct leadership of the National Health Commission (NHC), we should fulfill the responsibilities and obligations of the national team in promoting the construction of healthy China. We should not only take the lead in the whole country, but also step into the advanced ranks in the world as soon as possible, so as to contribute to the diagnosis, treatment and research of CTEPH patients in China.
 
CTEPH is the only type of 5 kinds of pulmonary hypertension that can be treated surgically, and PTE is the technical means to save patients with end-stage CTEPH. Due to the difficulty, time-consuming and high risk of PTE operation, PTE operation is not mature all over the world at present. There are less than 1,000 PTE operations in the world every year, and they are mainly concentrated in developed countries such as Europe and the United States. Although there are a large number of CTEPH patients in China, PTE operation is lagging behind developed medical centers in Europe and the United States. Only a few centers in China carry out PTE operation, and a large number of patients lose the opportunity of operation every year because they cannot get timely and effective diagnosis and treatment.
 
After its establishment in 2016, the CTEPH team of the CJFH went to the San Diego Medical Center (UCSD)of University of California, the largest CTEPH clinic in the world, where they  studied PTE surgery. At the beginning of 2017, team members could perform PTE operations on their own. Since then, 50 procedures have been completed. At present, the survival rate of patients who have completed the operation has reached 94%. Postoperative follow-up data shows that pulmonary artery pressure decreases by more than half in 98% of the patients, and 70% of the patients had normal pulmonary artery pressure. More than half of the patients could perform long-distance running, mountain climbing and other sports activities. Most of the patients resume their daily work and life after the surgery.
 
PTE surgery requires the removal of all thrombotic plaques that obstruct the pulmonary artery during cardiopulmonary bypass and deep hypothermic circulatory arrest. The operation lasted about 8 to 10 hours. Under the condition of low temperature blockade, the thrombus plaque should be removed carefully and completely, and the time should be minimized to protect the important organs. It has a high requirement for the technical exertion, experience and cooperation of the whole surgery team. Neurological damage has always been a major technical problem in PTE surgery. Globally, the incidence of neurological damage after PTE is 3-9%. Many patients suffer from neurological and psychiatric disorders after operation, which greatly reduces the effect of operation and causes heavy burden to patients and their families. CTEPH team of CJFH has established a complete system with the strong support of hospital leaders, functional departments, clinical departments and brother hospitals. It includes patient screening, indication grasping, preoperative rehabilitation, intraoperative norms of cardiovascular surgery and surgical anesthesia, smooth cooperation, post-operative monitoring, long-term management and follow-up of patients.
 
At present, the CTEPH diagnosis and treatment team is developing CTEPH diagnosis and treatment and PTE operation specifications suitable for China's national conditions as soon as possible, and has developed a complete intraoperative brain protection strategy based on foreign technology and its own experience. In the completed operation, no patient has occurred major neurological complications. It is bringing benefits to more patients with CTEPH.