TY - JOUR T1 - Prediction of outcome after PEA in chronic thromboembolic pulmonary hypertension using indexed pulmonary artery diameter JF - European Respiratory Journal JO - Eur Respir J SP - 909 LP - 912 DO - 10.1183/09031936.00174113 VL - 43 IS - 3 AU - Bastiaan E. Schölzel AU - Martijn C. Post AU - Steven Dymarkowski AU - Wim Wuyts AU - Bart Meyns AU - Werner Budts AU - Wim Morshuis AU - Repke J. Snijder AU - Marion Delcroix Y1 - 2014/03/01 UR - http://erj.ersjournals.com/content/43/3/909.abstract N2 - To the Editor:Chronic thromboembolic pulmonary hypertension (CTEPH) is associated with considerable morbidity and mortality [1]. It occurs in 2–4% of patients after acute pulmonary embolism [2]. Pulmonary endarterectomy (PEA) is the treatment of choice to relieve pulmonary artery obstruction in patients with CTEPH and has been remarkably successful [3]. However, in 10–50% of patients PEA is not possible due to either distal pulmonary vascular obstruction that is surgically inaccessible or significant comorbidities thought to be associated with an unacceptably high risk [4]. Therefore, careful selection of operable candidates is paramount. A correlation between the main pulmonary artery (PA) diameter and pulmonary haemodynamic parameters before PEA have been described in CTEPH patients [5]. We evaluated whether preoperative PA diameter indices could predict the occurrence of mortality and clinical worsening after PEA.A multidisciplinary panel including pulmonologists, radiologists, cardiologists, and cardiothoracic surgeons reviewed each case. Patients were considered suitable for surgery when they were symptomatic, had an elevated pulmonary vascular resistance (PVR) (>250 dyn·s·cm−5), segmental or more proximal lesions and no severe comorbidity. Before surgery all patients underwent standardised work-up as described earlier [4]. The study was approved by the local ethical committees of University Hospitals Leuven, Leuven and St Antonius Hospital, Nieuwegein.According to the study by Heinrich et al. [5], the widest diameters of the ascending aorta (Ao) and the widest diameter of the main PA perpendicular to its long axis were … ER -