Key result
Pulmonary endarterectomy improves functional class and hemodynamics, with ~4% one-year mortality in CTEPH.
Why the study?
Pulmonary endarterectomy remains the preferred and potentially curative option for CTEPH, but single-center outcome data from Iran were lacking.
Does pulmonary endarterectomy improve functional class, hemodynamics, and survival in patients with chronic thromboembolic pulmonary hypertension?
Cohort (n=42)
No
Does pulmonary endarterectomy improve functional class, hemodynamics, and survival in patients with chronic thromboembolic pulmonary hypertension?
Pulmonary endarterectomy for CTEPH can be performed safely with low mortality and significant hemodynamic and functional improvements in an experienced single center.
Supports pulmonary endarterectomy in operable cases; leaves open randomized confirmation of long-term outcomes.
Introduction Pulmonary endarterectomy (PEA) remains the preferred and potentially curative option for patients with chronic thromboembolic pulmonary hypertension (CTEPH). This study aimed to report the results of PEA for CTEPH in a tertiary center in Tabriz, Iran. Methods We analyzed the results of 42 CTEPH patients undergoing PEA, who were enrolled in the Tabriz University of Medical Sciences (TUMS-CTEPH) from January 2016 to October 2020. The main outcome measures included the New York Heart Association (NYHA) functional classification, the 6-Minute Walk Distance, hemodynamic measures in right heart catheterization, morbidity, and mortality. Results There was a significant improvement in the NYHA function class (2.6 ± 0.5 vs 1.1 ± 0.34), mean pulmonary arterial pressure (47.1 ± 13 vs 27.9 ± 8 mm Hg), cardiac output (4.3 ± 1.06 vs 5.9 ± 1.2 L/min), and pulmonary vascular resistance (709.4 ± 297.5 vs 214 ± 77 dyn s/cm5). Fifteen patients (35%) developed complications. The most common complication (10 [23%]) was reperfusion injury. Also, postsurgical mortality was 4% during hospital admission and 1-year follow-up. Conclusion This is the first single-center report of PEA from Iran. Post-PEA and 1-year survival were acceptable as a referral center. PEA can be performed safe with low mortality. Greater awareness of PEA and patients' access to experienced CTEPH centers are important issues.
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Parvizi et al. (2023) conducted a cohort in Chronic thromboembolic pulmonary hypertension (CTEPH) (n=42). Pulmonary endarterectomy (PEA) vs. Pre-operative baseline was evaluated on New York Heart Association (NYHA) functional classification, 6-Minute Walk Distance, hemodynamic measures, morbidity, and mortality. Pulmonary endarterectomy significantly improved NYHA functional class (2.6 to 1.1) and mean pulmonary arterial pressure (47.1 to 27.9 mm Hg), with a 4% mortality rate at 1-year follow-up.
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