Pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension. Ten years experience in Denmark.
OBJECTIVE
To evaluate survival and functional outcome in patients treated by pulmonary endarterectomy (PEA) for chronic thromboembolic pulmonary hypertension in Denmark.


METHODS
Follow-up of the first 50 patients operated at Aarhus University Hospital, Denmark.


RESULTS
Fifty patients underwent PEA in the period from 1994 to mid 2004. Prior to surgery all patients were in World Health Organization (WHO) function class III (n=33) or IV (n=17). The mean pulmonary artery pressure was 50 mmHg (range 25-76), cardiac index 1.8 l min(-1)m(-2) (range 0.8-2.8) and pulmonary vascular resistance 819 dyn s cm(-5) (range 241-3,067). In-hospital mortality was 12/50 (24%). Surgical mortality was highest in the early period. Since year 2000 in-hospital deaths occurred in only 2 among 23 patients (9%). Leading causes of death were persistent pulmonary hypertension and bleeding. Three patients died during long-term follow-up with a median observation time of 3 years. The overall 5 year survival rate was 74%. At 3 months follow-up 90% of the patients (34/38) had improved one or more WHO functional classes and the systolic pulmonary artery pressure estimated by Doppler echocardiography had decreased from 80 mmHg (range 49-115) to 43 mmHg (range 14-95).


CONCLUSIONS
Pulmonary endarterectomy has been successfully implemented in Denmark. The perioperative mortality was reduced over time to 9% during the past 5 years. Functional outcome and long-term survival were excellent stressing the importance of surgical treatment for chronic thromboembolic pulmonary hypertension.
Mellemkjaer
Søren
S
Department of Cardiology, Skejby Hospital, Aarhus University Hospital, Denmark.
Ilkjaer
Lars B
LB
Klaaborg
Kaj E
KE
Christiansen
Christian L
CL
Severinsen
Inge K
IK
Nielsen-Kudsk
Jens E
JE
Allermand
Henrik
H
Egeblad
Marianne
M
Kristensen
Bent O
BO
D000328:Adult; D000368:Aged; D003718:Denmark; D004691:Endarterectomy / Q000401:mortality / Q000592:standards; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D011651:Pulmonary Artery / Q000601:surgery; D011655:Pulmonary Embolism / Q000150:complications / Q000401:mortality / Q000601:surgery*; D012017:Referral and Consultation; D016019:Survival Analysis