Pulmonary thromboendarterectomy in 106 patients with chronic thromboembolic pulmonary hypertension.

Abstract Introduction Pulmonary thromboendarterectomy is the treatment of choice in chronic thromboembolic pulmonary hypertension. We report our experience with this technique. Methods Between February 1996 and June 2014, we performed 106 pulmonary thromboendarterectomies. Patient population, morbidity and mortality and the long-term results of this technique (survival, functional improvement and resolution of pulmonary hypertension) are described. Results Subjects’ mean age was 53±14 years. A total of 89% were WHO functional class III – IV , presurgery mean pulmonary pressure was 49±13 mmHg and mean pulmonary vascular resistance was 831±364 dynes s cm −5 . In-hospital mortality was 6.6%. The most important post-operative morbidity was reperfusion pulmonary injury, in 20% of patients; this was an independent risk factor ( P =.015) for hospital mortality. With a 31-month median follow-up (interquartile range: 50), 3- and 5-year survival was 90% and 84% respectively. At 1 year, 91% were WHO functional class I – II ; mean pulmonary pressure (27±11 mmHg) and pulmonary vascular resistance (275±218 dynes s cm −5 ) were significantly lower ( P Conclusions Pulmonary thromboendarterectomy offers excellent results in chronic thromboembolic pulmonary hypertension. Long-term survival is good, functional capacity improves, and pulmonary hypertension is resolved in most patients.