Is there a doctor in the house?

[WoVeU]

It seems I recall someone on here being a doctor...maybe someone was jesting.

Anyway I saw a show on a PPH case on Medical Mysteries I believe. I find it rather hard to believe that there are no bypass or stint type procedures to allow more blood flow through (around) the pulmonary artery. Is there something biological that precludes the use of this type of technology?

Now w/ their only being 500 - 1000 cases a year I could see there being less monetary benefit in engineering stints with a larger circumference. I know the low volume of cases lessens data and medical research available. It just seems this should be an operable condition once diagnosed. (I have a feeling the victims being primarily young women 20-40, compared to heart attacks and strokes being dominant in 45 and older males is a huge difference as well. (50 year old men have deeper pockets than 30 year old women.) I'm just really curious about this.

[Spence]

Can't help with the medical stuff. I don't know much.

[billybud]

Donovan would be the one that might know...but it is not his area of specialty.

I have stents...it is now a relatively simple procedure (they went in through the upper wrist although they can use the thigh). I suspect that you are right about frequency and the amount of research. Problems that occur at a very low relative frequency probably don't command the priority of other procedures.

[donovan]

This is most certainly not my area of expertise...but neither is football, so obviously that makes little difference to me.

The pulmonary artery delivers oxygenated blood to the lungs. This artery is susceptible to the same issues that are in other arteries.

The normal protocol for this blockage is drug therapy, some type of blood thinner. When there is a immediate blockage there are options.

The surgery is called pulmonary thromboendarterectomy, PTE, and it is an operation that removes clotted blood from the pulmonary arteries. The mortality of the procedure is between 5 and 10%.

What happens is the patient is put into a full cardiac arrest. Surgeons can not see what they are doing with massive blood flow so the flow is temporarily diverted. The patient then needs to be cooled down to protect the brain so the surgeon can operate, hypothermia is started. Remember, a full cardiac arrest has been induced. To remove the clots the surgeon has to use angioscopes..tv cameras... if he cuts too deep there is rupture and if too shallow the massive breaks up and the embolism moves. The operation is about six hours.

The recovery is critical and there are all kinds of issues, as you can imagine. These operations are done when there is time. They are successful.

Permanent bypass and grafting has not been that successful.

In an emergency a pulmonary thrombectomies is done. This is where time is a factor. These are not very successful but without it the patient will die, so something may be better than nothing.

So…I am not sure what the program was talking about because these procedures are done, not often because…well…at this point..the patient seldom makes it.

I can tell you unequivocally, that I do not see operations on an emergency basis not performed because of cost. Never. That may not make good TV…but it is a fact.

[WoVeU]

Thanks BB. I just hate to see a disease that seem to be such a killer, and can come out of nowhere, and kill people so young. But we got the limp biscuit fixed!

My memeory is terrible, my sister just told me last night that this is what my cousin's wife died from, she was like 30. His daughter looks to be headed in that direction...she is 16. (She had 2 sisters, all died from it before 30) I hated it, gone a lot, and don't see family back home enough. She was the only girl I think my cousin ever had, a simple country boy, he didn't even got out 'till he was in his early 30's...met her and married her. God I still hate to think about it.

[WoVeU]

The big guy weighed in! Thanks Donovan! The money...not stopping surgeries...not enough behind it (or cases) to develop higher developed procedures.


What a process...they documented the procedure and the girl had the tube to apply the medicine (thinner). Hers was about 7 or 8 if I recall...scary...but what are you going to do?