eISSN: 1897-4252
ISSN: 1731-5530
Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery
Current issue Archive Manuscripts accepted About the journal Supplements Editorial board Reviewers Abstracting and indexing Contact Instructions for authors Publication charge Ethical standards and procedures
Editorial System
Submit your Manuscript
SCImago Journal & Country Rank
Search
1/2011
vol. 8
 
Share:
Send email
Share:
abstract:

The risk of respiratory failure for chronic thromboembolic pulmonary hypertension patients after pulmonary endarterectomy

Piotr Szatkowski
,
Wojciech Dyk
,
Marcin Zygier
,
Ewa Sitkowska-Rysiak
,
Maria Wieteska
,
Adam Torbicki
,
Andrzej Biederman

Kardiochirurgia i Torakochirurgia Polska 2011; 8 (1): 96–100
Online publish date: 2011/04/13
View full text Get citation
 
Background: Chronic thromboembolic pulmonary hypertension (CTEPH) has poor long term prognosis [1, 2]. Pulmonary endar­terectomy (PEA) is a treatment of choice for patients with proximal location of thrombotic material [3].

Aim: Evaluation of post-PEA complication and its risk factors

with special reference to development of respiratory failure (RF).

Materials and methods: Records of 115 CTEPH patients,

80 males with a mean age of 53 ±13 (25-77) years, operated from October 1995 to April 2010 were reviewed. The patients were divided into two groups: group I without RF and group II with post-PEA RF. Hemodynamic data, procedural data and postoperative course were analysed.

Results: Respiratory failure occurred in 32 (28%) of the operated patients. The causes of RF were reperfusion pulmonary oedema (RPO) 26 (22,6%), persistent pulmonary hypertension (PPH) 11 (9,6%), airways bleeding 3 (2,6%). Seven patients died (6,1%). The patients with post-PEA RF (group II) were older (57 ±12 vs. 52 ±14; p = 0,0344) and had significantly higher mean pulmonary arterial pressure (PAP; 54 ±10

vs. 47 ±11 mm Hg; p = 0.0055) and preoperative pulmonary vascular resistance (PVR; 1015 vs. 584 dyn × s × cm–5;

p = 0.0020) and also longer extracorporeal circulation (ECC; 189 ±62 vs. 161 ±34 min, p = 0.0187) and cardiac arrest (CA;

43 ±17 vs. 32 ±16 min; p = 0.017).

Conclusion: Respiratory failure is a frequent complication after PEA. High PVR and PAP before PEA are risk factors of RF and death. RF occurs more frequently after PEA in elderly patients and in those with longer ECC and CA.
keywords:

chronic thromboembolic pulmonary hypertension, pulmonary endarterectomy, respiratory failure
Termedia
About us Contact
Copyright notice Privacy policy Advertising policy Contact us
Quick links
Journals Books eBooks Events
© 2024 Termedia Sp. z o.o.
Developed by Bentus.