Pulmonary Endarterectomy in Patients with Antiphospholipid Syndrome-Associated Chronic Thromboembolic Pulmonary Hypertension
Serpil Taş1, Arzu Antal1, Ali Fuad Durusoy2, Mehmed Yanartaş1, Kübra Yıldız3, Sehnaz Olgun Yıldızeli4, Derya Kocakaya4, Bülent Mutlu5, Fatma Alibaz-öner6, Haner Direskeneli6, Nevsun İnanç6, Atakan Erkılınç7, Bedrettin Yıldızeli81Department of Cardiovascular Surgery, University of Health Sciences, Kartal Koşuyolu Training and Research Hospital, İstanbul, Turkey2Department of Thoracic Surgery, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, İstanbul, Turkey 3Public Health Sciences, G
3Public Health Sciences, Gaziantep University, Gaziantep, Turkey
4Department of Pulmonology and Intensive Care, School of Medicine, Marmara University, İstanbul, Turkey
5Department of Cardiology, School of Medicine, Marmara University, İstanbul, Turkey
6Department of Internal Medicine, Division of Rheumatology, School of Medicine, Marmara University, İstanbul, Turkey
7Department of Anesthesia, University of Health Sciences, Kartal Koşuyolu Training and Research Hospital, İstanbul, Turkey
8Department of Thoracic Surgery, School of Medicine, Marmara University, İstanbul, Turkey
Background: Antiphospholipid syndrome is an autoimmune disease characterized by the occurrence of venous and/or arterial thrombosis. Chronic thromboembolism is one of the known established pathogenesis of pulmonary hypertension, known as chronic thromboembolic pulmonary hypertension. Pulmonary endarterectomy is the treatment of choice for chronic thromboembolic pulmonary hypertension. The aim of this study is to evaluate the efficacy and risk of pulmonary endarterectomy in patients with antiphospholipid syndrome-associated chronic thromboembolic pulmonary hypertension.
Methods: Data were prospectively collected and retrospectively analyzed, for patients who underwent pulmonary endarterectomy between March 2011 and March 2020.
Results: Seventeen patients (4 male and 13 female) were identified. Thirteen patients had primary antiphospholipid syndrome and 4 had secondary antiphospholipid syndrome. The mean age was 34.82 ± 10.07 years and the mean time interval between the diagnosis and surgery was 26.94 ± 17.35 months. Dyspnea on exertion was the main symptom in all patients. Seven patients had previous deep vein thrombosis, 5 patients had a history of recurrent abortions, and 2 patients had hemoptysis. Following surgery, mean pulmonary artery pressure decreased from 47.82 ± 13.11 mm Hg to 22.24 ± 4.56 mm Hg (P <.001),
and pulmonary vascular resistance improved from 756.50 ± 393.91 dyn/s/cm−5 to 298.31 ± 132.84 dyn/s/cm−5 (P <.001). There was no in-hospital mortality with a mean follow-up of 75.29 ± 40.21 months. The functional capacity of all patients improved from 269.46 ± 111.7 m to 490 ± 105.34 m on a 6-minute walking test.
Conclusions: Pulmonary endarterectomy is a safe and curative treatment in patients with antiphospholipid syndrome-associated chronic thromboembolic pulmonary hypertension. It has a favorable outcome by increasing the quality of life. A multidisciplinary
experienced chronic thromboembolic pulmonary hypertension team is critical in the management of these unique patients.
Corresponding Author: Serpil Taş
Manuscript Language: English
Journal Citation Indicator: 0.18
CiteScore: 1.1
Source Normalized Impact
per Paper: 0.22
SCImago Journal Rank: 0.348
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