Pulmonary Vascular Steal in Chronic Thromboembolic Pulmonary Hypertension: Methods (2)

In: Pulmonary function

13 Feb 2013

Pulmonary Vascular Steal in Chronic Thromboembolic Pulmonary Hypertension: Methods (2)The perfusion to each anatomic segment was visually scored as normal (2.0), decreased (0.5 to 1.5), or absent (0). Only those segments with normal ventilation were ranked. Steal was noted to have occurred when a lung segment score decreased by 1.0 or more between the preoperative vs the predischarge scan. The scans were scored by two of the authors (K.M.M., M.A.O.). There was interobserver agreement on the occurrence of steal in more than 90 percent of the segments. When disagreement existed, the segment was scored as showing no steal. Those scoring the scans Were blinded as to the patients name, the hemodynamic and angiographic data, and the findings at surgery. Cheap Diskus Advair
The preoperative pulmonary arteriogram was similarly scored. Lobar and segmental pulmonary arteries were judged to be normal (2.0), partially obstructed (1.0), or completely obstructed (0). In 15 patients, postoperative pulmonary arteriography was performed at 10 to 19 months after the operation and reviewed as above.
Statistical Analysis
The preoperative and postoperative hemodynamic variables in all 33 patients were analyzed using the paired t test. The Fishers exact test was used to assess the possible association of steal with the preoperative scan, the preoperative angiographic findings, and with whether the segmental arteries had been entered as a consequence of the endarterectomy procedure. The analysis was supplemented by review of the postoperative angiograms that were available. Values are reported as the mean± 1 SD. Statistical significance was accepted at the p<0.05 level for all analyses.


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