Outcomes of Pulmonary Endarterectomy Surgery
Section snippets
Patient Selection
We identified and followed all patients who underwent isolated pulmonary endarterectomy from May 1998 through April 2006 at our institution. This included 956 patients (468 male and 488 female patients) who comprise the most recent data set of the UCSD Pulmonary Endarterectomy Registry. The clinical presentation of the patients varied, from those with dyspnea on exertion but otherwise well to patients transferred by air ambulance in respiratory failure with florid right heart failure and
Results
All 956 patients underwent bilateral pulmonary endarterectomy with or without foramen ovale closure. Characteristics at the time of operation for patients who underwent pulmonary endarterectomy are detailed in Table 1. The mean patient age was 51.7 ± 15.4 years, with a range of 8.9 to 84.8 years. A similar number of men and women were referred for operation, reflecting disease predilection, surgical referral bias, or both. In 10% of cases, at least one additional cardiac procedure was performed
Conclusions
Pulmonary hypertension caused by chronic pulmonary embolism is under-recognized and carries a poor prognosis. Medical therapy for this condition is ineffective and only transiently improves symptoms. The only therapeutic alternative to pulmonary endarterectomy is lung transplantation. The advantages of pulmonary endarterectomy include a lower operative mortality (3-month survival for lung transplantation for pulmonary hypertension 1990-2001, 72%; for heart–lung transplantation for pulmonary
Acknowledgments
This work was supported by NIH Grant R01-HL70852 and Center for Medical Research and Education Grant to P.A.T.
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