ISSN 2149-2263 | E-ISSN 2149-2271
The Anatolian Journal of Cardiology
Pulmonary endarterectomy for patients with chronic thromboembolic disease [Anatol J Cardiol]
Anatol J Cardiol. 2018; 19(4): 273-278 | DOI: 10.14744/AnatolJCardiol.2018.37929

Pulmonary endarterectomy for patients with chronic thromboembolic disease

Şehnaz Olgun Yıldızeli1, Alper Kepez2, Serpil Taş4, Mehmed Yanartaş4, Ali Fuad Durusoy3, Atakan Erkılınç5, Bülent Mutlu2, Cihangir Kaymaz6, Hasan Sunar4, Bedrettin Yıldızeli3
1Department of Pulmonology and Intensive Care, Faculty of Medicine, Marmara University; İstanbul-Turkey
2Department of Cardiology, Faculty of Medicine, Marmara University; İstanbul-Turkey
3Department of Thoracic Surgery, Faculty of Medicine, Marmara University; İstanbul-Turkey
4Department of Cardiovascular Surgery, University of Health Sciences, Kartal Koşuyolu Hospital; İstanbul-Turkey
5Department of Anaesthesia, University of Health Sciences, Kartal Koşuyolu Hospital; İstanbul-Turkey
6Department of Cardiology, University of Health Sciences, Kartal Koşuyolu Hospital; İstanbul-Turkey

Objective: Chronic thromboembolic disease (CTED) is characterized by persistent pulmonary thromboembolic occlusions without pulmonary hypertension. Early surgical treatment by performing pulmonary endarterectomy (PEA) may improve symptoms. The goal of the study was to review our experience and early outcome of PEA in patients with CTED.
Methods: Data were prospectively collected on all patients who underwent PEA between 2011 and 2015. Patients with CTED and a mean pulmonary artery pressure (mPAP) of <25 mm Hg were identified. All patients were in New York Heart Association (NYHA) functional class II or III. Measured outcomes were in-hospital complications, improvement in cardiac function and exercise capacity, and survival after PEA. Patients were reassessed at 6 months following surgery.
Results: A total of 23 patients underwent surgery. There was no in-hospital mortality, but complications occurred in six patients (26%). At 6 months following surgery, 93% of the patients remained alive. Following PEA, the mPAP fell significantly from 21.0±2.7 mm Hg to 18.2±5.5 mm Hg (p<.001). Pulmonary vascular resistance also significantly decreased from 2.2±0.7 wood to 1.5±0.5 wood (p<.001). The 6-min walking distance significantly increased from 322.6±80.4 m to 379.9±68.2 m (p<.001). There was a significant symptomatic improvement in all survivors in NYHA functional classes I or II at 6 months following surgery (p=.001).
Conclusion: PEA in selected patients with CTED resulted in significant improvement in symptoms. The selection of patients for undergoing PEA in the absence of pulmonary hypertension must be made based on patients’ expectations and their acceptance of the perioperative risk.

Keywords: chronic thromboembolic disease, pulmonary endarterectomy, mortality, outcome

Şehnaz Olgun Yıldızeli, Alper Kepez, Serpil Taş, Mehmed Yanartaş, Ali Fuad Durusoy, Atakan Erkılınç, Bülent Mutlu, Cihangir Kaymaz, Hasan Sunar, Bedrettin Yıldızeli. Pulmonary endarterectomy for patients with chronic thromboembolic disease. Anatol J Cardiol. 2018; 19(4): 273-278

Corresponding Author: Bedrettin Yıldızeli, Türkiye
Manuscript Language: English


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Journal Citation Indicator: 0.18
CiteScore: 1.1
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