title: Pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension--A single-center experience in Taiwan.
abstract: OBJECTIVE
  Pulmonary endarterectomy (PEA) is a potentially curative surgical procedure for patients with chronic thromboembolic pulmonary hypertension. The aim of this study is to review our institutional experience with this operation.
  
  
  METHODS
  We conducted a retrospective review of PEA performed at our institution between January 2005 and December 2013. The measured outcomes were inhospital complications, improvement in cardiac function and exercise capacity, and actuarial survival after PEA.
  
  
  RESULTS
  Ten consecutive patients (7 women, 3 men) underwent PEA with a mean age of 59.9 ± 12.9 years. The preoperative New York Heart Association functional class (NYHA FC) for these patients was either Class III (n = 6) or Class IV (n = 4). The period from symptom onset to diagnosis was 34.3 ± 37.9 months, and that from diagnosis to operation was 31.4 ± 46.8 months. After PEA, the duration of intensive care unit stay and hospital stay prior to discharge were 9.7 ± 5.7 days and 18.7 ± 7.4 days, respectively. Postoperative complications included reperfusion lung edema (n = 3) and pneumonia (n = 1), and all recovered with medical therapy. After a mean follow-up of 48.4 ± 35.1 months, all patients showed marked improvements in their clinical status and were still alive without evidence of disease recurrence.
  
  
  CONCLUSIONS
  With proper patient selection, the cooperation of a multidisciplinary team, and meticulous postoperative management, PEA can be conducted safely with relatively low risk at a center with limited experience with the procedure.
authors.affiliation: Department of Surgery, National Taiwan University Hospital, Number 7, Chung-Shan South Road, Taipei, Taiwan; College of Medicine, National Taiwan University, Number 7, Chung-Shan South Road, Taipei, Taiwan.
authors.forename: Wei-Cheng
authors.initials: WC
authors.lastname: Luo
authors.affiliation: Department of Surgery, National Taiwan University Hospital, Number 7, Chung-Shan South Road, Taipei, Taiwan; College of Medicine, National Taiwan University, Number 7, Chung-Shan South Road, Taipei, Taiwan.
authors.forename: Shu-Chien
authors.initials: SC
authors.lastname: Huang
authors.affiliation: College of Medicine, National Taiwan University, Number 7, Chung-Shan South Road, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Number 7, Chung-Shan South Road, Taipei, Taiwan.
authors.forename: Yen-Hung
authors.initials: YH
authors.lastname: Lin
authors.affiliation: Department of Surgery, National Taiwan University Hospital, Number 7, Chung-Shan South Road, Taipei, Taiwan; College of Medicine, National Taiwan University, Number 7, Chung-Shan South Road, Taipei, Taiwan.
authors.forename: Hong-Shiee
authors.initials: HS
authors.lastname: Lai
authors.affiliation: Department of Surgery, National Taiwan University Hospital, Number 7, Chung-Shan South Road, Taipei, Taiwan; College of Medicine, National Taiwan University, Number 7, Chung-Shan South Road, Taipei, Taiwan.
authors.forename: Shuenn-Wen
authors.initials: SW
authors.lastname: Kuo
authors.affiliation: College of Medicine, National Taiwan University, Number 7, Chung-Shan South Road, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Number 7, Chung-Shan South Road, Taipei, Taiwan.
authors.forename: Sung-Ching
authors.initials: SC
authors.lastname: Pan
authors.affiliation: Department of Surgery, National Taiwan University Hospital, Number 7, Chung-Shan South Road, Taipei, Taiwan; College of Medicine, National Taiwan University, Number 7, Chung-Shan South Road, Taipei, Taiwan. Electronic address: ntuhsu@gmail.com.
authors.forename: Hsao-Hsun
authors.initials: HH
authors.lastname: Hsu
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000628:therapy; D004691:Endarterectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006976:Hypertension, Pulmonary / Q000601:surgery*; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000209:etiology; D011183:Postoperative Complications; D011651:Pulmonary Artery / Q000601:surgery*; D011654:Pulmonary Edema / Q000209:etiology; D011655:Pulmonary Embolism / Q000601:surgery*; D012189:Retrospective Studies; D013624:Taiwan; D016896:Treatment Outcome
keywords: chronic thromboembolic pulmonary hypertension; pulmonary endarterectomy