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• W2014760489 abstract "The surgical options available for pts with chronic thromboembolic pulmonary hypertension (CTEPH) are pulmonary thromboendarterectomy (PTE) and lung transplantation (LTx). Pts may be unsuitable for PTE because of the distribution of lesions or hemodynamic values. To determine the importance of these variables on outcome of PTE, we performed a retrospective analysis of the 66 CTEPH pts admitted to our Center since 1994. Fifty-three were judged suitable for PTE and 13 were listed for LTx. The criterion for selection was the distribution of pulmonary vascular obstructive lesions. Pts with central to segmental pulmonary arterial branch obstructions underwent PTE whereas pts with exclusively segmental and sub-segmental branch obstructions were listed for LTx. No pts were refused PTE because of poor hemodynamic values. Thus these were similar for the 2 groups (PTE/LTx mean±SD: PAPm 50±11 vs 56±12; CO 3.3±0.9 vs 3.2±1.5; PVR 1153±448 vs 1439±651). Two pts who had PTE were considered failures due to persistent pulmonary hypertension and were subsequently listed for LTx. Of the total 15 LTx pts, 9 were transplanted, 3 are still waiting, and 3 died on the list. Hospital mortality was not significantly different for the 2 groups (PTE 11.3% vs LTx 22.2%), nor was survival at 24 months (PTE 82.7% vs LTx 64.8%, p = 0.18 by Log-rank test). Highly compromised hemodynamic status was never associated with failure of PTE. Therefore, in our experience, all pts with exclusively segmental and sub-segmental obstructive lesions should be listed for LTx and all others with thromboembolic disease regardless their hemodynamic status are candidates for PTE. This strategy maximizes the use of scarce donor organs by offering non-transplant options when feasible for pts with CTEPH. Unfortunately for the pts listed for LTx mortality rate on the waiting list is high so long-term survival for LTx is worse than for PTE." @default.
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• W2014760489 date "2001-02-01" @default.
• W2014760489 modified "2023-10-17" @default.
• W2014760489 title "Surgical therapy for chronic thromboembolic pulmonary hypertension: criteria for choosing lung transplant vs trhomboendarterectomy" @default.
• W2014760489 doi "https://doi.org/10.1016/s1053-2498(00)00477-0" @default.
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