Pulmonary Endarterectomy in Pediatric Patients: Institutional Experience

Area of Science:

• Pediatric Cardiology
• Cardiovascular Surgery
• Pulmonary Hypertension Research

Background:

• Chronic thromboembolic pulmonary hypertension (CTEPH) is uncommon in children, with limited data on surgical interventions.
• Pulmonary endarterectomy (PEA) experience in pediatric patients is scarce.

Purpose of the Study:

• To evaluate the feasibility and outcomes of PEA in pediatric patients with CTEPH.
• To assess the safety and efficacy of PEA in children, including those with comorbidities.

Main Methods:

• Retrospective review of seven PEA procedures in six pediatric patients (<18 years).
• Analysis of clinical characteristics, perioperative findings, hemodynamic data, and follow-up.
• Inclusion of patients with diverse risk factors and comorbidities.

Main Results:

• Median age was 13 years; most patients presented with severe pulmonary hypertension (WHO functional class III/IV).
• Post-PEA, mean pulmonary artery pressure decreased from 39 ± 15 mmHg to 21 ± 4 mmHg, and PVRi from 7.51 ± 4.56 to 2.36 ± 1.36 U·m².
• One in-hospital mortality; other patients showed significant recovery with short ICU and hospital stays.

Conclusions:

• PEA is a safe and effective treatment for carefully selected pediatric CTEPH patients.
• The procedure leads to substantial hemodynamic and functional improvements.
• PEA offers a potentially curative option for this rare pediatric condition.