Outcomes of Pulmonary Endarterectomy Operation Concomitant with Cardiac Procedures

Abstract

Background The aim of this study was to analyze the results of pulmonary endarterectomy (PEA) performed simultaneously with additional cardiac procedures in a single tertiary-level center.

Methods Data of patients who underwent PEA with additional cardiac procedures for chronic thromboembolic pulmonary hypertension (CTEPH) in our clinic were retrospectively reviewed using patient records.

Results Between March 2011 and April 2019, 56 patients underwent PEA with additional cardiac surgery. The most common additional procedure was coronary artery bypass grafting (21 patients; 38%). The median intensive care unit and hospital stays were 4 (3–6) days and 10 (8–14) days. Mortality was recorded in six patients (11%). In multivariate analysis, only preoperative pulmonary vascular resistance (PVR) (p = 0.02; odds ratio [OR]: 1.003) and cardiopulmonary bypass duration (p = 0.02; OR: 1.028) were associated with mortality. When the cutoff value of 1000 dyn.s.cm⁻⁵ was taken in the receiver operating characteristic curve analysis, preoperative PVR predicted mortality with 83% sensitivity and 94% specificity (area under curve = 0.89; p < 0.01).

Conclusion PEA for CTEPH may be performed safely with other cardiac operations. This type of surgery is a complex procedure that should be performed only in expert centers. Patients with high preoperative PVR are at increased risk of perioperative complications.

Keywords

cardiac - coronary artery bypass grafting - CABG - pulmonary vascular resistance/hypertension - cardiopulmonary bypass - CPB

Authors' Contributions

Study conception and design: Hasan Erdem, Oktay Korun, Bedrettin Yildizeli.

Acquisition of data: Hasan Erdem, Oktay Korun, Mehmed Yanartaş, Serpil Taş, Benay Erden, Onur Yerlikhan, Atakan Erkilinç, Cihangir Kaymaz, Hasan Sunar, Bedrettin Yildizeli.

Analysis and interpretation of data: Oktay Korun, Bedrettin Yildizeli.

Drafting of manuscript: Hasan Erdem, Oktay Korun, Bedrettin Yildizeli.

Critical revision: Hasan Erdem, Oktay Korun, Mehmed Yanartaş, Serpil Taş, Benay Erden, Onur Yerlikhan, Atakan Erkilinç, Cihangir Kaymaz, Hasan Sunar, Bedrettin Yildizeli.

Herewith we all declare that we agree to all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Publikationsverlauf

Eingereicht: 07. Januar 2020

Angenommen: 06. April 2020

Artikel online veröffentlicht:
01. August 2020

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