Survival and quality of life for patients with peripheral type chronic thromboembolic pulmonary hypertension.
BACKGROUND
The validity of pulmonary thromboendarterectomy for treatment of relatively peripheral type of chronic thromboembolic pulmonary hypertension (CTEPH) remains uncertain. The survival and quality of life (QOL) of patients with relatively peripheral type of CTEPH was investigated at follow up.


RESULTS
Between April 1999 and March 2006, 83 consecutive patients with CTEPH were evaluated for surgical indication and underwent computed tomography angiography. The extent of central disease was scored (ie, CD score), and a CD score of <or=1 was judged as relatively peripheral disease. Forty-three patients were excluded from surgery, and 40 patients, including 14 cases of relatively peripheral disease, underwent surgery. Long-term survival and QOL scores at follow up (1-3 years) were compared between the surgically and medically treated groups of relatively peripheral disease. Survival curves between the 2 treatment groups were not significantly different (p=0.78) because of high operative mortality (21.4%). However, improvement in physical functioning, role function (physically related), general health perception (as assessed by the Medical Outcome Study Short Form 36), and baseline dyspnea index were significantly higher in the group treated surgically compared with the medically treated group.


CONCLUSIONS
Pulmonary thromboendarterectomy offers better QOL even in those patients with relatively peripheral type of CTEPH, although operative mortality must be reduced.
Yoshimi
Seishi
S
Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Tanabe
Nobuhiro
N
Masuda
Masahisa
M
Sakao
Seiichiro
S
Uruma
Takahiro
T
Shimizu
Hidefumi
H
Kasahara
Yasunori
Y
Takiguchi
Yuichi
Y
Tatsumi
Koichiro
K
Nakajima
Nobuyuki
N
Kuriyama
Takayuki
T
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage; D000959:Antihypertensive Agents / Q000008:administration & dosage; D002908:Chronic Disease; D004691:Endarterectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D011237:Predictive Value of Tests; D011379:Prognosis; D011655:Pulmonary Embolism / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index; D017131:Thrombectomy; D014665:Vasodilator Agents / Q000008:administration & dosage
D000925:Anticoagulants; D000959:Antihypertensive Agents; D014665:Vasodilator Agents