Journal List > Tuberc Respir Dis > v.59(6) > 1000886

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Kim, Hong, Lee, Hong, Oh, Shim, Lim, Koh, Kim, Kim, Kim, and Lee: Effects of Pulmonary Thromboendarterectomy in Patients with Chronic Thromboembolic Pulmonary Hypertension
Original Article

Tuberculosis and Respiratory Diseases 2005; 59(6): 644-650.

Published online: 31 December 2005

DOI: https://doi.org/10.4046/trd.2005.59.6.644

Effects of Pulmonary Thromboendarterectomy in Patients with Chronic Thromboembolic Pulmonary Hypertension

Hyun Kuk Kim, M.D.1, Suck Chan Hong, M.D.1, Jae Won Lee, M.D.2, Sang-Bum Hong, M.D.1, Yeon-Mok Oh, M.D.1, 3, Tae Sun Shim, M.D.1, Chae-Man Lim, M.D.1, Younsuck Koh, M.D.1, Woo Sung Kim, M.D.1, Dong Soon Kim, M.D.1, 3, Won Dong Kim, M.D.1, Sang-Do Lee, M.D.1, 3

1Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Korea.

2Department of Thoracic and Cardiovascular Surgery, University of Ulsan College of Medicine, Asan Medical Center, Korea.

3Clinical Research Center for Chronic Obstructive Airway Diseases, Seoul, Korea.

Address for correspondence: Sang-Do Lee, M.D. Department of Internal medicine, University of Ulsan College of Medicine, Asan Medical Center 388-1 Pungnap-dong, Songpa-gu, Seoul 138-736, Korea. Phone: 82-2-3010-3140, Fax: 82-2-3010-6968, sdlee@amc.seoul.kr

Received 22 August 2005       Accepted 29 September 2005

Copyright©2005. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

Methods

Bilateral pulmonary thromboendarterectomy(PTE) is recognized as the definitive treatment for chronic thromboembolic pulmonary hypertension (CTEPH). We investigated the symptomatic, hemodynamic and prognostic effects of PTE in comparison with medical treatment.

Methods

Twenty-four patients diagnosed with CTEPH from 1995 to 2003 at the Asan Medical Center were divided into two groups: patients treated with PTE(PTE group, n=12) and those not treated with PTE(Med group, n=12). The serial changes in dyspnea, the tricuspid regurgitation maximal velocity (TRVmax) and survival of the PTE and Med groups were compared retrospectively.

Results

In PTE group, during a follow-up period of 1 year, the New York Heart Association(NYHA) functional class significantly improved, while there was no significant improvement in the Med group. PTE significantly lowered the TRVmax from 4.23±0.54 m/sec to 3.22±0.70 m/sec over a follow up period of 2 years. (p=0.028) However, the TRVmax in the medically treated group did not show any significant improvement, changing from 3.98±0.68 m/sec to 4.27±0.95 m/sec during 1 year. The 5-year survival of the PTE group was 77.9% compared with 64.3% in the medically treated group.

Conclusion

PTE provides substantial long-term improvement in dyspnea and the echocardiographic changes compared with medically treated patients.

Keywords: chronic thromboembolic pulmonary hypertension, pulmonary thromboendarterectomy

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