Key result
A lower preoperative aortopulmonary index (≤0.88 for the ascending aorta) significantly predicted a lower risk of residual pulmonary hypertension 1 year after pulmonary endarterectomy.
Why the study?
The study aimed to assess whether computed tomography pulmonary angiography can predict residual pulmonary hypertension in patients with chronic thromboembolic pulmonary hypertension after pulmonary endarterectomy.
Does the preoperative aortopulmonary index measured by CTPA predict residual pulmonary hypertension in patients with CTEPH undergoing pulmonary endarterectomy?
Cohort (n=131)
Radiologists blinded to clinical and hemodynamic data
No
Does the preoperative aortopulmonary index measured by CTPA predict residual pulmonary hypertension in patients with CTEPH undergoing pulmonary endarterectomy?
p-value: p=0.033
Preoperative CTPA-derived aortopulmonary index is a useful prognostic marker for predicting residual pulmonary hypertension after pulmonary endarterectomy in CTEPH patients.
OBJECTIVES: This study aimed to retrospectively assess using computed tomography pulmonary angiography (CTPA) for predicting residual pulmonary hypertension (RPH) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) after pulmonary endarterectomy (PEA). METHODS: We retrospectively analyzed data of 131 patients with CTEPH who underwent PEA in our center (2008-2015). We measured several diameters of the pulmonary artery and thoracic aorta preoperatively. We evaluated the relationship between these measurements (and their indices) and signs of RPH represented by pulmonary artery systolic pressure (PASP) estimated by echocardiography. RESULTS: Significant correlations were observed between the aortopulmonary index and prediction of any residual hypertension and moderate/severe hypertension 1 year after PEA, and any residual hypertension and severe hypertension 2 years after PEA. The aortopulmonary index was significantly related to a reduction in PASP 1 year after the operation. A lower aortopulmonary index (≤0.88 for the ascending aorta and ≤0.64 for the descending aorta) predicted lower RPH. CONCLUSIONS: Preoperative CTPA parameters can be used to assess the risk of RPH after PEA. The aortopulmonary index has significant predictive value for RPH and a reduction in PASP after PEA. Lower values of the aortopulmonary index suggest a better outcome after PEA.
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Nižňanský et al. (2021) conducted a cohort in Chronic thromboembolic pulmonary hypertension (CTEPH) (n=131). Preoperative aortopulmonary index (Ao/PA and DAo/PA) vs. Higher aortopulmonary index values was evaluated on Prediction of any residual pulmonary hypertension (PASP > 35 mmHg) 1 year after pulmonary endarterectomy using the ascending aortopulmonary index (Ao/PA) (p=0.033). A lower preoperative aortopulmonary index (≤0.88 for the ascending aorta) significantly predicted a lower risk of residual pulmonary hypertension 1 year after pulmonary endarterectomy.
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