Long-term outcomes of surgery for chronic thromboembolic pulmonary hypertension compared with medical therapy at a single Korean center.
- Author:
Soo Han KIM
1
;
Jae Won LEE
;
Jung Min AHN
;
Dae Hee KIM
;
Jong Min SONG
;
Sang Do LEE
;
Jae Seung LEE
Author Information
- Publication Type:Original Article
- Keywords: Korea; Pulmonary embolism; Hypertension, pulmonary; Surgery; Survival
- MeSH: Arterial Pressure; Diagnosis; Echocardiography; Endarterectomy; Hemodynamics; Humans; Hypertension, Pulmonary*; Korea; Multivariate Analysis; Peas; Pulmonary Embolism; Retrospective Studies; Survival Rate; Tricuspid Valve Insufficiency; World Health Organization
- From:The Korean Journal of Internal Medicine 2017;32(5):855-864
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Pulmonary endarterectomy (PEA) is the gold standard for treating chronic thromboembolic pulmonary hypertension (CTEPH) in Western countries. The aim of this study was to investigate the long-term outcomes of performing PEA on CTEPH patients in comparison with medical therapy at a single Korean center. METHODS: This retrospective study included 88 CTEPH patients. These patients were classified into the PEA group (n = 37) or non-PEA group (i.e., medical therapy; n = 51). The clinical characteristics, hemodynamic data, and long-term survival rates were compared. Independent prognostic factors for CTEPH were also investigated. RESULTS: CTEPH was not associated with either gender, and the mean age at diagnosis was 53.3 ± 13.7 years. Echocardiography revealed that the mean peak velocity of the tricuspid regurgitation jet was 4.2 ± 0.7 m/sec and the mean pulmonary arterial pressure was 51.7 ± 15.1 mmHg. The PEA and non-PEA groups demonstrated no significant differences, except in terms of the right ventricular end-diastolic diameter. The survival rates of the PEA group were significantly higher than the non-PEA group at 1, 3, 5, and 10 years (p = 0.032). Multivariate analyses indicated that World Health Organization class IV and PEA were significant predictors of poorer and better outcomes, respectively. CONCLUSIONS: PEA demonstrates more favorable effects on long-term survival than medical therapy in Korean CTEPH patients who were considered operable.
