首页 | 本学科首页   官方微博 | 高级检索  
     


Chronic thromboembolic pulmonary hypertension: surgical treatment with thromboendarterectomy
Authors:José Antonio Blázquez  Pilar Escribano  Enrique Pérez  María Jesús López  Miguel Ángel Gómez  José María Cortina
Affiliation:1. Institute of Cardiology and Center of Excellence on Aging “G. d’Annunzio” University of Chieti, Italy;2. University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
Abstract:Background and objectivesPulmonary thromboendarterectomy (PTE) is considered the potential curative treatment for chronic thromboembolic pulmonary hypertension (CTEPH). We analysed the results of the PTE application in our institution.Patients and methodsFrom February 1996 to December 2007, 30 patients with CTEPH underwent videoassisted PTE. Preoperative hemodynamic data were: systolic pulmonary artery pressure (SPAP) 87±17 mmHg, mean pulmonary artery pressure (MPAP) 51±11 mmHg, pulmonary total resistance 1067±485 dynes·s·cm?5, pulmonary vascular resistance 873±389 dynes·s·cm?5 and cardiac index 2.2±0.5 l/min/m2. We analysed the influence of several factors on hospital mortality and survival, and we performed partial analysis of mortality since 2004.ResultsPTE resulted in significant improvements in SPAP (P<0.001), MPAP (P=0.001) and cardiac index (P<0.001). Hospital mortality was 17% (5/30) (95% confidence interval, 6%-35%). From 2004, it dropped to 5% (1/20) (95% confidence interval, 0%-25%). Hospital mortality was influenced by preoperative pulmonary total resistance, preoperative pulmonary vascular resistance, postoperative SPAP, reduction of SPAP, reduction of MPAP, reperfusion pulmonary oedema and residual postoperative pulmonary hypertension (P=0.036; P=0.018;P=0.013; P=0.050; P=0.050; P=0.030; P=0.045). Survival after PTE, including hospital mortality, was 76±9% at 10 years. Through long-term follow-up, functional status (P=0.001), 6 min walking distance (P=0.001), end-diastolic right ventricle size (P<0.001), and tricuspid regurgitation (P<0.001) significantly improved.ConclusionsPTE effectively reduces pulmonary hypertension and offers CTEPH patients a substantial improvement in survival and quality of life.
Keywords:
本文献已被 ScienceDirect 等数据库收录!
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号