Hemodynamic profiles in patients with chronic thromboembolic disease before and after pulmonary endarterectomy

2015 ◽  
Author(s):  
Coen Van Kan ◽  
Mart Van der Plas ◽  
Herre Reesink ◽  
Reindert Van Steenwijk ◽  
Robert Tepaske ◽  
...  
Keyword(s):  
Thromboembolic Disease ◽  
Pulmonary Endarterectomy ◽  
Before And After ◽  
Chronic Thromboembolic Disease

scholarly journals Exercise right heart catheterisation before and after pulmonary endarterectomy in patients with chronic thromboembolic disease

2018 ◽  
Vol 52 (3) ◽  
pp. 1800458 ◽  
Author(s):  
Stefan Guth ◽  
Christoph B. Wiedenroth ◽  
Andreas Rieth ◽  
Manuel J. Richter ◽  
Ekkehard Gruenig ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Thromboembolic Disease ◽  
Pulmonary Endarterectomy ◽  
Right Heart ◽  
Heart Catheterisation ◽  
Right Heart Catheterisation ◽  
Before And After ◽  
The Mean ◽  
Chronic Thromboembolic Disease ◽  
The Impact

Symptomatic patients with chronic thromboembolic disease (CTED) without pulmonary hypertension often show an excessive increase in mean pulmonary arterial pressure (MPAP) during exercise.We report on the impact of pulmonary endarterectomy (PEA) on pulmonary haemodynamics in a prospective series of 32 consecutive CTED patients who underwent PEA. All patients had a comprehensive diagnostic work-up including right heart catheterisation at baseline and 12 months after PEA. Furthermore, in 12 patients exercise right heart catheterisation was performed before and after PEA.After PEA, MPAP was lower at rest (20±3 versus 17±3 mmHg; p=0.008) and during maximal exercise (39±8 versus 31±6 mmHg; p=0.016). The mean total pulmonary resistance (TPR) decreased from 3.6±0.8 Wood Units (WU) pre-operatively to 2.7±0.7 WU 1 year after PEA (p=0.004) and the mean slope of the MPAP/cardiac output (CO) relationship decreased from 3.6±1.0 to 2.3±0.8 WU (p=0.002). Peak oxygen uptake increased from 1.2±0.4 to 1.5±0.3 L·min−1 (p=0.014) and ventilatory equivalents of carbon dioxide decreased from 39±2 to 30±2 (p=0.002). There was a significant improvement in quality of life assessed by the Cambridge Pulmonary Hypertension Outcome Review questionnaire.In CTED patients, PEA resulted in haemodynamic and clinical improvements. The means of TPR and MPAP/CO slopes decreased to <3.0 WU.

scholarly journals Outcome of pulmonary endarterectomy in symptomatic chronic thromboembolic disease

2014 ◽  
Vol 44 (6) ◽  
pp. 1635-1645 ◽  
Author(s):  
Dolores Taboada ◽  
Joanna Pepke-Zaba ◽  
David P. Jenkins ◽  
Marius Berman ◽  
Carmen M. Treacy ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pulmonary Hypertension ◽  
Heart Association ◽  
Symptomatic Improvement ◽  
Thromboembolic Disease ◽  
Pulmonary Endarterectomy ◽  
Surgical Morbidity ◽  
Right Heart Catheterisation ◽  
Chronic Thromboembolic Disease

Chronic thromboembolic disease is characterised by persistent pulmonary thromboembolic occlusions without pulmonary hypertension. Early surgical treatment with pulmonary endarterectomy may improve symptoms and prevent disease progression. We sought to assess the outcome of pulmonary endarterectomy in symptomatic patients with chronic thromboembolic disease.Patients with symptomatic chronic thromboembolic disease and a mean pulmonary artery pressure <25 mmHg at baseline with right heart catheterisation and treated with pulmonary endarterectomy between January 2000 and July 2013 were identified. Patients were reassessed at 6 months and at 1 year following surgery.A total of 42 patients underwent surgery and the median length of stay in hospital was 11 days. There was no in-hospital mortality but complications occurred in 40% of patients. At 1 year, following surgery, 95% of the patients remained alive. There was a significant symptomatic improvement with 95% of patients in the New York Heart Association functional classes I or II at 6 months. There was a significant improvement in quality of life assessed by the Cambridge pulmonary hypertension outcome review questionnaire.In this carefully selected cohort of chronic thromboembolic disease patients, pulmonary endarterectomy resulted in significant improvement in symptoms and quality of life. Appropriate patient selection is paramount given the known surgical morbidity and mortality, and surgery should only be performed in expert centres.

scholarly journals Functional Characterization of Patients with Chronic Thromboembolic Disease

Respiration ◽  
2016 ◽  
Vol 91 (6) ◽  
pp. 503-509 ◽  
Author(s):  
Matthias Held ◽  
Philipp Kolb ◽  
Maria Grün ◽  
Berthold Jany ◽  
Gudrun Hübner ◽  
...  
Keyword(s):  
Functional Characterization ◽  
Thromboembolic Disease ◽  
Chronic Thromboembolic Disease
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