title: Outcome of Medically Versus Surgically Treated Patients With Chronic Thromboembolic Pulmonary Hypertension.
abstract: Chronic thromboembolic pulmonary hypertension (CTEPH) is an ominous disease leading to progressive right heart failure. Selected patients can be treated by pulmonary endarterectomy (PEA). We assessed long-term clinical outcome of patients with CTEPH who underwent PEA and patients who remained on medical treatment alone. A total of 112 consecutive patients with CTEPH referred between 1998 and 2008 to one center were followed for a mean of 35 (range 0-128) months after diagnosis. All the patients had advanced pulmonary hypertension at baseline. The operated group had higher World Health Organization functional class compared to the nonoperated group. No other differences in hemodynamic, echocardiographic, or biochemical parameters were observed at baseline. Despite the perioperative mortality rate of 9.1%, patients who underwent PEA had significantly lower long-term mortality compared to nonoperated patients (12.7% vs 34.8%; P = .003), and PEA survivors showed sustained clinical improvement. All efforts should be undertaken to perform PEA in all patients with operable CTEPH.
authors.affiliation: Department of Pulmonary Circulation and Thromboembolic Diseases, Centre of Postgraduate Medical Education, Otwock, Poland mwiet@poczta.onet.pl.
authors.forename: Maria
authors.initials: M
authors.lastname: Wieteska
authors.affiliation: Department of Cardiac Surgery, Allenort Hospital, Warsaw, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Biederman
authors.affiliation: Department of Pulmonary Circulation and Thromboembolic Diseases, Centre of Postgraduate Medical Education, Otwock, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Kurzyna
authors.affiliation: Department of Cardiac Surgery, Allenort Hospital, Warsaw, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Dyk
authors.affiliation: Intensive Pneumo-Cardiological Treatment Unit, Institute of Tuberculosis and Lung Diseases, Warsaw, Poland.
authors.forename: Janusz
authors.initials: J
authors.lastname: Burakowski
authors.affiliation: Institute of Tuberculosis and Lung Diseases, Warsaw, Poland.
authors.forename: Liliana
authors.initials: L
authors.lastname: Wawrzyńska
authors.affiliation: First Pulmonary Department, Institute of Tuberculosis and Lung Diseases, Warsaw, Poland.
authors.forename: Monika
authors.initials: M
authors.lastname: Szturmowicz
authors.affiliation: Department of Cardiology, Institute of Mother and Child, Warsaw, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Fijałkowska
authors.affiliation: Department of Anesthesiology, Institute of Cardiology, Warsaw-Anin, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Szatkowski
authors.affiliation: Department of Pulmonary Circulation and Thromboembolic Diseases, Centre of Postgraduate Medical Education, Otwock, Poland.
authors.forename: Adam
authors.initials: A
authors.lastname: Torbicki
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006976:Hypertension, Pulmonary / Q000097:blood / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000097:blood / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D015996:Survival Rate
keywords: prognostic factors; pulmonary endarterectomy; pulmonary hypertension; pulmonary thromboembolism; right heart failure; survival