Assessment of central hemodynamic parameters after pulmonary thrombendarterectomy in patients with chronic thromboembolic pulmonary hypertension

Osadchii AM, Zugurov IKh, Simakova MA, Marukyan NV, Vorobyeva AV, Moiseeva OM, Gordeev ML. Assessment of central hemodynamic parameters after pulmonary thrombendarterectomy in patients with chronic thromboembolic pulmonary hypertension. Russian Journal of Cardiology and Cardiovascular Surgery. 2024;17(6):637‑645. (In Russ.)
https://doi.org/10.17116/kardio202417061637

Подписка 2026 Кардиология и сердечно-сосудистая хирургия (Russian Journal of Cardiology and Cardiovascular Surgery)

Использование инфографики авторами научных работ

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OBJECTIVE

To analyze central hemodynamic parameters, incidence of residual pulmonary hypertension (RPH), complications and functional status of patients in early postoperative period after pulmonary thromboendarterectomy (PTE).

MATERIAL AND METHODS

The study included 42 patients with chronic thromboembolic pulmonary hypertension who underwent PTE under deep hypothermic circulatory arrest between 2018 and 2022. There were 13 women (mean age 43.8±12.2 years) and 29 men (mean age 55.2±12.8 years). Mean pulmonary artery pressure (PAP) and pulmonary vascular resistance were 59 mm Hg [47; 65] and 11.1 Wood units [6.8; 15.1], respectively. The median size of the right ventricle (RV) along the long axis was 51.5 mm [43; 57], tricuspid annular plane systolic excursion — 16 mm [13; 19].

RESULTS

Intraoperatively, mean PAP significantly decreased to 24 mm Hg (p<0.001), while PAP reduction degree was 44%. Upon admission to the intensive care unit, mean PAP (before weaning from ventilator) was 21.5 mm Hg (p<0.001), after extubation — 20 mm Hg (dependent variables before and after extubation did not differ significantly, p>0.05). Eventually, 8 (19%) patients had RPH at discharge from the intensive care unit. There was no early postoperative mortality.

CONCLUSION

Positive reverse remodeling of pulmonary vessels and RV follows PTE in early postoperative period. The incidence of RPH was 19%, and in-hospital period in the group with and without RPH did not significantly differ in mortality. Functional status of patients without RPH significantly improved in early postoperative period.

Keywords:

chronic thromboembolic pulmonary hypertension

hemodynamics

pulmonary thromboendarterectomy

Authors:

Osadchii A.M.

Almazov National Medical Research Centre

ORCID: 0000-0003-4709-617X

Zugurov I.Kh.

Almazov National Medical Research Centre

ORCID: 0000-0002-5589-932X

Simakova M.A.

Almazov National Medical Research Centre

ORCID: 0000-0001-9478-1941

Marukyan N.V.

Almazov National Medical Research Centre

ORCID: 0000-0003-0736-6278

Vorobyeva A.V.

Almazov National Medical Research Centre

ORCID: 0009-0003-9089-2208

Moiseeva O.M.

Almazov National Medical Research Centre

ORCID: 0000-0002-7817-3847

Gordeev M.L.

Almazov National Medical Research Centre

SPIN RSCI: 6776-3079
Scopus AuthorID: 7003704352
ORCID: 0000-0001-5362-3226

Received:

17.12.2023

Accepted:

26.04.2024

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