Pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension: Outcomes of 60 consecutive procedures

Background: Chronic thromboembolic pulmonary hypertension (CTEPH) is the only form of pulmonary hypertension that is potentially curable by pulmonary endarterectomy (PEA). We report the outcomes of 60 consecutive PEA procedures performed by a single surgeon in a centre with a relatively low annual case volume. Materials and methods: Retrospective analysis of 60 consecutive patients who underwent surgery between September 2017 and November 2025. Surgery was performed using a modified version of the Royal Papworth Hospital protocol, with cardiopulmonary bypass and deep hypothermic circulatory arrest (DHCA). Demographic and perioperative data were analysed. Haemodynamic measurements were obtained preoperatively by right-heart catheterisation, intraoperatively immediately after separation from cardiopulmonary bypass, and on the following morning (postoperative day 1). Results: Mean age was 47.8 ± 13.7 years; 35 patients (58.3%) were male and 25 (41.7%) were female. WHO functional class was III in 34 patients (56.7%) and IV in 26 (43.3%). Mean preoperative mPAP was 53.0 ± 14.7 mmHg and mean PVR was 782 ± 291 dyn·s·cm-⁵. Thirty-day mortality was 2/60 (3.3%). One of the two patients who died had pulmonary artery sarcoma (diagnostic error). Thirty-day mortality in confi rmed CTEPH was 1/59 (1.7%). Among survivors, mean PVR reduction on POD1 was 60.3 ± 12.9%; 39/58 (67.2%) achieved a reduction ≥ 55%. Conclusions: This series of 60 consecutive procedures demonstrates low 30-day mortality and signifi cant haemodynamic benefi t. After exclusion of the diagnostic error, 30-day mortality in confi rmed CTEPH is even lower. Despite the programme’s relatively low annual volume, these outcomes are comparable with those reported by established high-volume expert centres