Original articleAdult cardiacPulmonary Endarterectomy: Recent Changes in a Single Institution's Experience of More Than 2,700 Patients
Section snippets
Selection
The purpose of this study was to determine whether our experience with sicker patients with more distal disease now being referred to our center adversely affected outcome. A retrospective review of our database identified 1,500 patients with CTEPH who underwent pulmonary endarterectomy at UCSD between March 1999 and December 2010. For the purposes of this study, informed consent was waived and data collected in accordance with the standards set by UCSD's Institutional Review Board. Patients
Results
All patients underwent bilateral pulmonary endarterectomy. The mean patient age was 51.6 years, with a range of 8 to 86 years. The preoperative characteristics of both patient groups are summarized in Table 1. Preoperative hemodynamic measurements revealed a trend toward a lower PVR in the most recent patient group. However there was a statistically significant increase in the number of group 2 patients requiring intravenous inotropes before operation, and although not achieving statistical
Comment
Over the past decade, a wide variety of new medical therapies have been developed for the treatment of pulmonary hypertension. These include prostacyclin analogues, phosphodiesterase inhibitors, and endothelium receptor antagonists [3, 4, 5]. There has been an increased use of these medical therapies in patients with CTEPH. As a consequence, we are seeing a delay in patient referrals, even in patients who have obvious operable disease. In 2010, 45% of patients with operable CTEPH referred for
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