A decrease in mean pulmonary arterial pressure >10.4% under inhaled nitric oxide predicts long-term survival and freedom from lung transplantation in patients with CTEPH undergoing endarterectomy.
Cohort (n=103)
Does acute pulmonary vasoreactivity testing with inhaled nitric oxide predict postoperative outcomes in patients with chronic thromboembolic pulmonary hypertension undergoing pulmonary endarterectomy?
Acute pulmonary vasoreactivity testing with inhaled nitric oxide identifies patients with CTEPH who are likely to have better long-term survival and freedom from lung transplantation after pulmonary endarterectomy.
BACKGROUND: Surgical pulmonary endarterectomy is the preferred treatment for chronic thromboembolic pulmonary hypertension. Persistent pulmonary hypertension after pulmonary endarterectomy has been recognized as a major determinant of poor outcome. We tested whether acute vasoreactivity identifies chronic thromboembolic pulmonary hypertension patients prone to develop persistent/recurrent pulmonary hypertension after pulmonary endarterectomy and whether the degree of acute vasoreactivity affects survival or freedom from lung transplantation. METHODS AND RESULTS: Right-sided heart catheterization at baseline and after inhalation of 40 ppm nitric oxide for 20 minutes was performed in 103 patients (56.3+/-15.3 years old, 53 women). Reductions in mean pulmonary arterial pressure (DeltamPAP; -8.8+/-12.6%; P10.4% with nitric oxide inhalation had a better postoperative outcome. A significant correlation was found between DeltamPAP and immediate postoperative pulmonary vascular resistance (r=0.5, P10.4% under inhaled nitric oxide is a predictor of long-term survival and freedom from lung transplantation in adult patients with chronic thromboembolic pulmonary hypertension who are undergoing pulmonary endarterectomy.
Skoro‐Sajer et al. (Thu,) conducted a cohort in Chronic thromboembolic pulmonary hypertension (n=103). Inhaled nitric oxide (acute vasoreactivity testing) vs. Baseline was evaluated on Persistent/recurrent pulmonary hypertension, long-term survival, and freedom from lung transplantation. A decrease in mean pulmonary arterial pressure >10.4% under inhaled nitric oxide predicts long-term survival and freedom from lung transplantation in patients with CTEPH undergoing endarterectomy.
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