04 February 2019

Single Center Experience of Pulmonary Thromboendarterectomy for Chronic Thromboembolic Pulmonary Hypertension

 Introduction:

Pulmonary thromboendarterectomy, remains the preferred and potentially curative option for patients with chronic thromboembolic pulmonary hypertension (CTEPH). The objective of this study was to report the result of pulmonary thromboendarterectomy (PEA) for chronic thromboembolic pulmonary hypertension (CTEPH) in a single tertiary center.

Method:

Here we report 29 CTEPH patients who underwent PEA between September 2015 and September 2017. Mean pulmonary artery pressure (PAP) and mean pulmonary vascular resistance before surgery were 42+-15 mmHg (20-64 mmHg) and 769.8 dynes · sec1 · cm5+- 511 (150 to 1850 ) respectively. The main outcome measures were Functional New York Heart Association [NYHA] class, 6‑Minute Walk Distance, hemodynamic measures in right heart catheterization, morbidity and mortality. There were significant improvement in function class (p2.6+-0.5 vs. 1.08+-0.2, p=0.00), mean PAP (47.6+-12 mmHg vs. post 29.7+-9.1 mmHg, p=0.000), cardiac output ( 4.7+-1.4 l/min vs. post 5.5+-1.2, p= 0.00 ), and pulmonary vascular resistance (769+-515 dynes • sec 1 • cm 5 vs. 302+-141 dynes • sec 1 • cm 5, p= 0.00 ). Eight patients (27%) developed complications.. The most common complication was reperfusion injury (%17). There was 4.2% post-surgical mortality during hospital admission.

Conclusion:

Pulmonary thromboendarterectomy can be safely performed with relatively low mortality and favorable prognosis. This surgery should be performed in an expert center with multidisiplinery team work.

 

Key word: pulmonary hypertension, Thromboendarterectomy, chronic thromboembolism

Key Contributors

Farid Rashidi, MD 1, Rezayat Parvizi 2, Eisa Bilejani 2, Ata Koohi 1 : 1 Tuberclosis and lung disease research center, Tabriz University of Medical Sciences, Tabriz, Iran 2 Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran


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