نتائج عمليات تجريف خثرات و بطانة الشرايين الرئوية لمعالجة ارتفاع التوتر الرئوي الصمي-الخثري المزمن في مركز وحيد في الشرق الأوسط

Abstract EN

Objective: Pulmonary thrombo-endarterectomy (PEA) is the treatment of choice for chronic thromboembolic pulmonary hypertension (CTEPH), but is only performed in few Middle-Eastern centers.

We reviewed our 10 years’ experience with PEA in order to define the risks and functional and prognostic results in patients with CTEPH.

Methods: Eighteen patients (mean age 37.2±9.2 years) underwent standard PEA surgery.

All patients were in functional class III or IV states pre-operatively.

According to Jamieson classification, 14 patients had type I or II CTEPH lesions, and 4 patients had type III or IV CTEPH lesions.

Results: One patient died early post-operatively due to acute right ventricular failure, but there were no other perioperative complications.

Systolic pulmonary artery pressures (sPAP) decreased before leaving hospital from 80.1±21.6 mmHg to 45±14 mmHg (p=0.033), and arterial oxygen saturations (SpO2) increased from 91±7% to 96±5% (p=0.028).

Three months post-operatively, sPAP decreased further to 41±18 mmHg and SpO2 increased to 97±4%.

These changes were accompanied with advancing 88.8% of patients by more than one NYHA functional class.

Eleven patients were followed for 30.8±46.2 months, with survival rates reaching 81.8% at 5 years.

Conclusions: PEA in our experience was a relatively low-risk procedure, and resulted in satisfactory long-term outcomes, with significant improvements in hemodynamics, symptoms and prognoses.