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Long-term outcome after pulmonary thromboendarterectomy
C J Archibald1, W R Auger, P F Fedullo
1Division of Pulmonary and Critical Care Medicine and Division of Cardiothoracic Surgery, University of California, San Diego, San Diego, California, USA. carchibald@UCSd.edu
American Journal of Respiratory and Critical Care Medicine
|August 3, 1999
Summary
Pulmonary thromboendarterectomy (PTE) significantly improves survival and quality of life for chronic thromboembolic pulmonary hypertension (CTEPH) patients. Post-surgery, patients experience reduced symptoms and minimal healthcare use.
Area of Science:
- Cardiology
- Pulmonary Medicine
- Surgical Outcomes
Background:
- Chronic thromboembolic pulmonary hypertension (CTEPH) is a severe condition often leading to poor outcomes.
- Pulmonary thromboendarterectomy (PTE) is a surgical option for CTEPH, but long-term results require further evaluation.
Purpose of the Study:
- To assess the long-term outcomes of PTE in CTEPH patients.
- To evaluate survival, functional status, quality of life, and healthcare utilization post-PTE.
- To explore relationships between postoperative hemodynamics and patient outcomes.
Main Methods:
- A postal survey was sent to 420 patients more than 1 year post-PTE; 308 responded.
- Data collected included survival, functional capacity (e.g., 6-minute walk test), quality of life (Rand SF-36), and healthcare utilization.
- Postoperative pulmonary vascular resistance (PVR) was correlated with clinical and functional parameters.
Main Results:
- Long-term survival after PTE was 75% at over 6 years.
- Significant improvements in symptoms, functional capacity (median walk 5,280 ft), and return to work (62%) were observed.
- Quality of life scores improved significantly compared to pre-PTE, with minimal disease-related hospitalizations.
Conclusions:
- PTE offers substantial long-term benefits for CTEPH patients, including improved survival, function, and quality of life.
- Postoperative pulmonary hemodynamics are linked to functional capacity and quality of life.
- PTE is associated with minimal disease-related healthcare utilization in CTEPH patients.
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