Abstract
Introduction: Data regarding chronic thromboembolic pulmonary disease (CTEPD) without pulmonary hypertension (PH) and its management are scarce.
Method: This study describes the characteristics and outcome of a cohort of CTEPD patients without PH according to the type of management, in the French PH referral centre. Demographics were compared to a cohort of 426 CTEPH patients treated meanwhile.
Results: 39 CTEPD without PH patients were evaluated from 2015 to 2020 (mean pulmonary artery pressure 20.6 (±3.3) mmHg and pulmonary vascular resistance 153 (±48) dyn.s.cm-5). CTEPD without PH patients were younger (p<0.0001) and more likely to have had a previous pulmonary embolism (p<0.01), when compared to CTEPH patients. 22 CTEPD without PH patients (56%) were deemed operable and 12 underwent pulmonary endarterectomy (PEA), which significantly improved symptoms (p<0.05) and hemodynamics (p=0.015). PEA was associated with a rate of transient complications of 33%. Among the 17 inoperable patients (44%), 4 underwent balloon pulmonary angioplasty, which improved symptoms. 22 of 39 patients (56%) were followed without intervention. This subgroup was less symptomatic (p=0.02) and had a higher cardiac index (p=0.02), when compared to the interventional subgroup. Untreated patients remained clinically stable after a median follow-up of 42 months.
Conclusions: CTEPD without PH patients should be thoroughly assessed prior to instrumental treatment. PEA significantly improves symptoms and hemodynamics but is associated with a substantial rate of complications. A subgroup of CTEPD without PH patients appears clinically stable when treated conservatively.
Footnotes
Cite this article as Eur Respir J 2022; 60: Suppl. 66, 919.
This article was presented at the 2022 ERS International Congress, in session “-”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
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