What does this research mean for the field?

Residual pulmonary hypertension occurred in 22.6% of patients after pulmonary thromboendarterectomy, with older age and pulmonary vascular resistance (PVR) >321 dynes/sec/cm-5 on day one as key predictors. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

January 10, 2026Open Access

Long-term outcomes of pulmonary thromboendarterectomy: predictors of residual pulmonary hypertension

DKD.B. KurbanovaWeatherford College KMK.V. MershinNational Medical Research Center of Cardiology NDNM DanilovNational Medical Research Center of Cardiology

Key Result

Residual pulmonary hypertension occurred in 22.6% of patients after TEE, with age and PVR >321 dynes/sec/cm-5 on day one as key predictors.

Key Points

This study aims to identify predictors of residual pulmonary hypertension after pulmonary thromboendarterectomy in patients with chronic thromboembolic pulmonary hypertension.
Conducted a retrospective observational study with 58 patients who underwent pulmonary thromboendarterectomy.
Evaluated long-term outcomes with a median follow-up of 66 months.
Assessed residual pulmonary hypertension criteria via right heart catheterization and echocardiography.
Performed statistical analysis, including ROC analysis for predictor sensitivity and specificity.
The 5-year cumulative survival rate among patients was 94.6%.
Residual pulmonary hypertension was noted in 22.6% of surviving patients.
Older age and higher pulmonary vascular resistance on the first postoperative day were significant predictors of residual hypertension.
Patients with pulmonary vascular resistance greater than 321 dynes/sec/cm-5 on the first day had a 75% sensitivity for developing residual hypertension.

Structured PICO

What are the predictors of residual pulmonary hypertension in patients with CTEPH following pulmonary thromboendarterectomy?

Population

58 patients with chronic thromboembolic pulmonary hypertension (CTEPH) who underwent pulmonary thromboendarterectomy (TEE) in 2016-2020

Intervention

Pulmonary thromboendarterectomy (TEE)

Outcome

Residual pulmonary hypertension (mPAP ≥25 mmHg according to right heart catheterization or sPAP ≥40 mmHg according to echocardiography)surrogate

Older age and a pulmonary vascular resistance >321 dynes/sec/cm-5 on the first postoperative day are significant predictors of residual pulmonary hypertension after pulmonary thromboendarterectomy.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Introduction. Pulmonary thromboendarterectomy (TEE) is the gold standard of treatment for patients with chronic thromboembolic pulmonary hypertension (CTEPH). Residual pulmonary hypertension (PH) may worsen prognosis of disease after TEE, and incidence reaches 40%. Identification of risk factors of residual PH in long-term period after surgery is an actual issue. Material and methods. A retrospective observational study included 58 patients with CTEPH who underwent TEE in 2016—2020. We studied long-term results and obtained data in 96.6% patients (n=56); median follow-up was 66 (57—78) months. The primary endpoint was residual PH as mPAP ≥25 mmHg according to right heart catheterization (RHC) or sPAP ≥40 mmHg according to echocardiography. Statistical analysis was performed. Sensitivity and specificity of predictors of residual PH were analyzed using ROC analysis (cut-off value was established using Youden index). Results. The 5-year cumulative survival rate was 94.6%. Recurrence of pulmonary embolism was diagnosed in 1 patient (1.7%). Among survivors, residual PH was diagnosed in 12 (22.6%) patients. Patients in this group were older (61.2±8.7 vs. 49.8±13.2 years, p=0.007) and had higher PVR on the first day after TEE (361.8±130.3 vs. 250.7±82.2 dynes/sec/cm-5, p321 dynes/sec/cm-5 on the 1st day after surgery is associated with high risk of residual PH.

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