Medical and Surgical Management for Chronic Thromboembolic Pulmonary Hypertension: A Single Center Experience |
| |
Institution: | 1. Department of Cardiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8560, Japan;2. Department of Advanced Medicine in Cardiopulmonary Disease, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8560, Japan;1. Department of Advanced Medicine in Cardiopulmonary Disease, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan;2. Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan;3. Department of Rehabilitation Science, Nagoya University Graduate School of Medicine, Nagoya 461-8673, Japan;1. State Key Laboratory of Severe Weather, Chinese Academy of Meteorological Sciences, Beijing 100081, China;2. Laboratory of Lightning Physics and Protection Engineering, Chinese Academy of Meteorological Sciences, Beijing 100081, China;3. Collaborative Innovation Center on Forecast and Evaluation of Meteorological Disasters, Nanjing University of Information Science & Technology, Nanjing 210044, China;4. Lightning Protection Center of Guangdong Province, Guangzhou 510080, China |
| |
Abstract: | IntroductionPulmonary endarterectomy (PE) is the treatment of choice for chronic thromboembolic pulmonary hypertension (CTEPH). The aim of this study was to analyze our experience in the medical and surgical management of CTEPH.MethodsWe included 80 patients diagnosed with CTEPH between January 2000 and July 2012. Thirty-two patients underwent PE and 48 received medical treatment (MT). We analyzed functional class (FC), 6-min walking distance (6MWD), and pulmonary hemodynamics. Mortality in both groups and periods were analyzed.ResultsPatients who underwent PE were younger, mostly men, and had longer 6MWD. No differences were observed in pulmonary hemodynamics or FC at diagnosis. One year after treatment, all PE patients versus 41% in MT group were at FC I–II. At follow-up, the PE group showed greater increase in 6MWD, and greater reduction in mean pulmonary arterial pressure and pulmonary vascular resistance than the MT group (P<.05). Overall survival in the MT group at 1 and 5 years was 83% and 69%, respectively. Conditional survival in patients alive 100 days post-PE at 1 and 5 years was 95% and 88%, respectively. Surgical mortality in operated patients in the first period (2000–2006) was 31.3%, and 6.3% in the second (2007–2012).ConclusionsPE provides good clinical results, and improves pulmonary hemodynamics in patients who successfully overcome the immediate postoperative period. After a learning period, the current operatory mortality in our center is similar to international standards. |
| |
Keywords: | Chronic thromboembolic pulmonary hypertension Pulmonary endarterectomy Pulmonary hypertension Pulmonary circulation Pulmonary hemodynamics Hipertensión pulmonar tromboembólica crónica Endarterectomía pulmonar Hipertensión pulmonar Circulación pulmonar Hemodinámica pulmonar |
本文献已被 ScienceDirect 等数据库收录! |
|