The Korean journal of internal medicine

  • 제32권5호
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  • Pages.855-864
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  • 2017
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  • 1226-3303(pISSN)
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  • 2005-6648(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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Long-term outcomes of surgery for chronic thromboembolic pulmonary hypertension compared with medical therapy at a single Korean center

  • Kim, Soo Han (Department of Internal Medicine, Center for Pulmonary Hypertension and Venous Thrombosis, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Jae Won (Department of Thoracic and Cardiovascular Surgery, Center for Pulmonary Hypertension and Venous Thrombosis, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ahn, Jung-Min (Department of Cardiology, Center for Pulmonary Hypertension and Venous Thrombosis, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Dae-Hee (Department of Cardiology, Center for Pulmonary Hypertension and Venous Thrombosis, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Song, Jong-Min (Department of Cardiology, Center for Pulmonary Hypertension and Venous Thrombosis, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Sang-Do (Department of Pulmonary and Critical Care Medicine, Center for Pulmonary Hypertension and Venous Thrombosis, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Jae Seung (Department of Pulmonary and Critical Care Medicine, Center for Pulmonary Hypertension and Venous Thrombosis, Asan Medical Center, University of Ulsan College of Medicine)
  • 투고 : 2016.02.22
  • 심사 : 2016.06.29
  • 발행 : 2017.09.01
⟨ 이전 논문 다음 논문 ⟩

초록

Background/Aims: Pulmonary endarterectomy (PEA) is the gold standard for treating chronic thromboembolic pulmonary hypertension (CTEPH) in Western countries. The aim of this study was to investigate the long-term outcomes of performing PEA on CTEPH patients in comparison with medical therapy at a single Korean center. Methods: This retrospective study included 88 CTEPH patients. These patients were classified into the PEA group (n = 37) or non-PEA group (i.e., medical therapy; n = 51). The clinical characteristics, hemodynamic data, and long-term survival rates were compared. Independent prognostic factors for CTEPH were also investigated. Results: CTEPH was not associated with either gender, and the mean age at diagnosis was $53.3{\pm}13.7years$. Echocardiography revealed that the mean peak velocity of the tricuspid regurgitation jet was $4.2{\pm}0.7m/sec$ and the mean pulmonary arterial pressure was $51.7{\pm}15.1mmHg$. The PEA and non-PEA groups demonstrated no significant differences, except in terms of the right ventricular end-diastolic diameter. The survival rates of the PEA group were significantly higher than the non-PEA group at 1, 3, 5, and 10 years (p = 0.032). Multivariate analyses indicated that World Health Organization class IV and PEA were significant predictors of poorer and better outcomes, respectively. Conclusions: PEA demonstrates more favorable effects on long-term survival than medical therapy in Korean CTEPH patients who were considered operable.

키워드

참고문헌

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피인용 문헌

  1. Life expectancy after pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension: a Swedish single‐center study vol.10, pp.2, 2017, https://doi.org/10.1177/2045894020918520