Effects of Pulmonary Thromboendarterectomy in Patients with Chronic Thromboembolic Pulmonary Hypertension.

Kim, Hyun Kuk; Hong, Suck Chan; Lee, Jae Won; Hong, Sang Bum; Oh, Yeon Mok; Shim, Tae Sun; Lim, Chae Man; Koh, Younsuck; Kim, Woo Sung; Kim, Dong Soon; Kim, Won Dong; Lee, Sang Do

doi:2005.59.6.644

Tuberc Respir Dis > Volume 59(6); 2005 > Article

Original Article

Tuberculosis and Respiratory Diseases 2005;59(6):644-650.
DOI: https://doi.org/10.4046/trd.2005.59.6.644 Published online December 1, 2005.

Effects of Pulmonary Thromboendarterectomy in Patients with Chronic Thromboembolic Pulmonary Hypertension.

Hyun Kuk Kim, Suck Chan Hong, Jae Won Lee, Sang Bum Hong, Yeon Mok Oh, Tae Sun Shim, Chae Man Lim, Younsuck Koh, Woo Sung Kim, Dong Soon Kim, Won Dong Kim, Sang Do Lee

¹Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Korea. sdlee@amc.seoul.kr
²Department of Thoracic and Cardiovascular Surgery, University of Ulsan College of Medicine, Asan Medical Center, Korea.
³Clinical Research Center for Chronic Obstructive Airway Diseases, Seoul, Korea.

Abstract

BACKGROUND
Bilateral pulmonary thromboendarterectomy(PTE) is recognized as the definitive treatment for chronic thromboembolic pulmonary hypertension (CTEPH). We investigated the symptomatic, hemodynamic and prognostic effects of PTE in comparison with medical treatment. METHODs: Twenty-four patients diagnosed with CTEPH from 1995 to 2003 at the Asan Medical Center were divided into two groups: patients treated with PTE(PTE group, n=12) and those not treated with PTE(Med group, n=12). The serial changes in dyspnea, the tricuspid regurgitation maximal velocity (TRVmax) and survival of the PTE and Med groups were compared retrospectively. RESULTS: In PTE group, during a follow-up period of 1 year, the New York Heart Association(NYHA) functional class significantly improved, while there was no significant improvement in the Med group. PTE significantly lowered the TRVmax from 4.23+/-0.54 m/sec to 3.22+/-0.70 m/sec over a follow up period of 2 years. (p=0.028) However, the TRVmax in the medically treated group did not show any significant improvement, changing from 3.98+/-0.68 m/sec to 4.27+/-0.95 m/sec during 1 year. The 5-year survival of the PTE group was 77.9% compared with 64.3% in the medically treated group. CONCLUSION: PTE provides substantial long-term improvement in dyspnea and the echocardiographic changes compared with medically treated patients.

Key Words: chronic thromboembolic pulmonary hypertension, pulmonary thromboendarterectomy