Patients with chronic thromboembolic pulmonary hypertension (CTEPH) who underwent pulmonary endarterectomy (PEA) had a higher risk for late cardiac events if their postoperative mean pulmonary artery pressure was >30 mm Hg, according to study results published in the Annals of Thoracic Surgery.

Perioperative measurements and follow-up data were retrospectively analyzed from patients with CTEPH undergoing PEA. Before undergoing PEA, all patients received pulmonary vasodilator treatment. The preoperative mean pulmonary artery pressure was 47 mm Hg. Associations between these data points and treatment results were then evaluated for possible predictors of early and late outcomes.

Of the 122 patients with CTEPH who underwent PEA, in-hospital mortality was 7.4%. The overall survival rates were 91.8%, 89.2%, 89.2%, 89.2%, and 86.1%, at 1, 3, 5, 7, and 10 years, respectively. In addition, the cardiac event-free rates were 100%, 98.1%, 95.8%, 85.5%, and 49.0% at 1, 3, 5, 7, and 10 years, respectively. A postoperative mean pulmonary artery pressure >30 mm Hg was the only predictor for late cardiac events.

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“Early outcomes of surgical PEA for CTEPH with perioperative aggressive pulmonary vasodilator treatment seem satisfactory,” the researchers wrote. “However, residual pulmonary hypertension remains challenging to achieve further improvement of late outcomes.”

Reference

Sakurai Y, Takami Y, Amano K, et al. Predictors of outcomes after surgery for chronic thromboembolic pulmonary hypertension [published online May 7, 2019]. Ann Thorac Surg. doi:10.1016/j.athoracsur.2019.03.100