Pulmonary endarterectomy in chronic thromboembolic pulmonary hypertension
Section snippets
Methods
All patients admitted to the Kerckhoff Clinic, Bad Nauheim, Germany, for scheduled PEA between January 2014 and December 2015 were considered eligible for inclusion in the present prospective, non-interventional cohort study. The Kerckhoff Clinic serves as a national referral center for PEA, with >100 PEA procedures performed per year. The diagnosis of CTEPH was established by the referring physician (in most cases at national PH expert centers) according to current guidelines.16 Operability
Patient cohort
Between January 1, 2014, and December 31, 2015, 253 patients with CTEPH underwent PEA (alone or in combination with BPA); 237 (93.7%) of these patients were included in the study (Figure 1). Patients excluded did not differ with regard to baseline characteristics, symptoms, functional status, medication, risk factors for CTEPH, comorbidities, and outcome (data not shown). Most of the patients (219 [92.4%]) were transferred to Bad Nauheim from centers in Germany, and 18 further patients were
Discussion
PEA is the only potentially curative treatment for patients with CTEPH.1, 5, 6, 7, 8 During the past decade, improvements in surgical techniques and supportive intensive care and, most importantly, understanding of the importance of interdisciplinary team approaches in experienced PEA centers have resulted in decreased in-hospital mortality rates after PEA. In the most recently operated patients, 2 of the largest PEA centers worldwide reported favorable in-hospital mortality rates of 2.2% and
Disclosure statement
None of the authors reports a conflict of interest related to the submitted work. The following authors report financial activities outside the submitted work: M.L. reports having received consultancy and lecture honoraria from Actelion, Bayer, Daiichi-Sankyo, MSD, Pfizer, and Bristol-Myers-Squibb C.L. reports having received lecture honoraria from Abbott, Astra Zeneca, Bayer, Berlin Chemie, Boehringer Ingelheim, Daiichi-Sankyo, Pfizer, and Bristol-Myers-Squibb and payment for travel
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Evaluation and management of patients with chronic thromboembolic pulmonary hypertension - consensus statement from the ISHLT
2021, Journal of Heart and Lung TransplantationCitation Excerpt :Early and long-term outcomes after PEA are excellent when performed in expert CTEPH centers. The hospital mortality is currently 2 to 3% and the 5-year survival greater than 70% in surgical centers performing more than 50 PEAs per year.84,85,214,220,223-225 The risks of PEA depends on the location of the disease in the pulmonary artery, the severity of right heart failure and the degree of comorbidities.
Risk factors for chronic thromboembolic pulmonary hypertension – Importance of thyroid disease and function
2020, Thrombosis ResearchCitation Excerpt :Diagnosis of CTEPH was confirmed based on current guideline recommendations [2]. The study protocol and clinical data of the study cohort have been reported previously [17]. Briefly, information on comorbidities, risk factors for CTEPH, medication, results from clinical tests such as RHC, transthoracic echocardiography (TTE), 6-minute walk test (6MWT) and laboratory measurements, surgical procedure and in-hospital course were collected using a standardized case report form.
2018 TSOC guideline focused update on diagnosis and treatment of pulmonary arterial hypertension
2019, Journal of the Formosan Medical AssociationCitation Excerpt :CTEPH is a potential curable disease and PEA is the first-line treatment.6 Hemodynamics, functional parameter, and quality of life improved in most patients after PEA.154–157 After PEA, up to one third of patients after PEA may have persistent pulmonary hypertension because of incomplete removal of thrombi or concomitant distal pulmonary vasculopathy.
Predictors of Outcomes After Surgery for Chronic Thromboembolic Pulmonary Hypertension
2019, Annals of Thoracic SurgeryCitation Excerpt :Our first finding was that PEA was an effective surgical therapeutic option for patients with CTEPH to obtain immediate improvement in pulmonary hemodynamics and satisfactory late outcomes. Our in-hospital mortality was 7.4% and was 4.8% in the subgroup of 103 patients treated after 2007, which were lower than the rates reported in most previous studies,4,8,9,12,13 although they were still higher than those from the San Diego group.5,6,11,15 Several factors are likely to contribute to a favorable early outcome of PEA.
Chronic thromboembolic pulmonary hypertension
2023, PneumologieChronic thromboembolic pulmonary hypertension
2023, Deutsche Medizinische Wochenschrift
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These authors have contributed equally to this work.