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Pulmonary Hypertension: A Contraindication for Lung Volume Reduction Surgery?
Sowmyanarayanan Thuppal1, Traves Crabtree1, Stephen Markwell1
1Division of Cardiothoracic Surgery, Department of Surgery, Southern Illinois University School of Medicine, Springfield, Illinois.
The Annals of Thoracic Surgery
|October 15, 2019
Summary
Lung volume reduction surgery (LVRS) shows similar outcomes for emphysema patients with pulmonary hypertension (PH) compared to those without. This suggests LVRS may be a viable option for select patients with PH.
Area of Science:
- Pulmonary Medicine
- Cardiology
- Thoracic Surgery
Background:
- Pulmonary hypertension (PH) was historically a contraindication for lung volume reduction surgery (LVRS).
- Recent evidence suggests LVRS can be successful in carefully selected emphysema patients with PH.
Purpose of the Study:
- To evaluate in-hospital and 1-year functional and quality of life (QOL) outcomes in emphysema patients with PH undergoing LVRS.
- To compare outcomes between patients with and without PH post-LVRS.
Main Methods:
- Retrospective analysis of 124 patients undergoing LVRS, identifying 56 with PH (mean PAP 41 mm Hg).
- PH defined by right heart catheterization or echocardiogram (pulmonary artery pressure >35 mm Hg).
- In-hospital outcomes and 1-year functional parameters (lung function, 6-minute walk distance) and QOL were assessed.
Main Results:
- In-hospital outcomes were comparable between patients with and without PH.
- Significant improvements in lung function, 6-minute walk distance, and QOL were observed at 1-year follow-up in patients with PH.
- No significant differences in baseline or follow-up functional and QOL outcomes between the two groups.
Conclusions:
- Outcomes for emphysema patients with PH undergoing LVRS were similar to those without PH in this cohort.
- LVRS may be a potential therapeutic option for select emphysema patients with PH.
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