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Thorac Cardiovasc Surg 2021; 69(03): 279-283
DOI: 10.1055/s-0040-1710580
Original Cardiovascular

Outcomes of Pulmonary Endarterectomy Operation Concomitant with Cardiac Procedures

Hasan Erdem
1   Department of Cardiovascular Surgery, Health Sciences University Kartal Koşuyolu Training and Research Hospital, İstanbul, Turkey
,
Oktay Korun 
2   Pediatric Cardiac Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
,
Mehmed Yanartaş
1   Department of Cardiovascular Surgery, Health Sciences University Kartal Koşuyolu Training and Research Hospital, İstanbul, Turkey
,
Serpil Taş
1   Department of Cardiovascular Surgery, Health Sciences University Kartal Koşuyolu Training and Research Hospital, İstanbul, Turkey
,
Benay Erden
1   Department of Cardiovascular Surgery, Health Sciences University Kartal Koşuyolu Training and Research Hospital, İstanbul, Turkey
,
Onur Yerlikhan
1   Department of Cardiovascular Surgery, Health Sciences University Kartal Koşuyolu Training and Research Hospital, İstanbul, Turkey
,
Atakan Erkilinç
3   Department of Anesthesia, Health Sciences University Kartal Koşuyolu Training and Research Hospital, İstanbul, Turkey
,
Cihangir Kaymaz
4   Department of Cardiology, Health Sciences University Kartal Koşuyolu Training and Research Hospital, İstanbul, Turkey
,
Hasan Sunar
1   Department of Cardiovascular Surgery, Health Sciences University Kartal Koşuyolu Training and Research Hospital, İstanbul, Turkey
,
Bedrettin Yildizeli
5   Department of Thoracic Surgery, Marmara University School of Medicine, İstanbul, Turkey
› Author Affiliations Funding None.
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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.




Publication History

Received: 07 January 2020

Accepted: 06 April 2020

Article published online:
01 August 2020

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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