Figures
- FIGURE 1
Effects of pulmonary vascular resistance (PVR) at diagnosis on in-hospital and 1-year mortality in patients with chronic thromboembolic pulmonary hypertension (CTEPH) undergoing pulmonary endarterectomy. Data from the international CTEPH registry [23]. *: p<0.05 compared with group with PVR >1200 dyn·s·cm-5.
Tables
- TABLE 1
Outcomes of pulmonary endarterectomy in patients with proximal (type 1 and type 2) or distal (type 3) chronic thromboembolic pulmonary hypertension (CTEPH) disease distribution
Proximal Distal Subjects n 221 110 mPAP mmHg Pre-operative 44±10 46±11 At discharge 22±7 24±6 3-month follow-up 24±9 25±7 12-month follow-up 23±7 24±8 p-value# <0.001 <0.001 PVR dyn·s·cm–5 Pre-operative 876±392 926±337 At discharge 251±146 295±161 3-month follow-up 270±175 300±139 12-month follow-up 243±115 300±224 p-value# <0.001 <0.001 PaO2 mmHg Pre-operative 65±12 66±11 3-month follow-up 82±13 80±11 12-month follow-up 80±11 80±11 p-value# <0.001 <0.001 Modified Bruce exercise test m Pre-operative 51 (0−143) 52 (0−102) 3-month follow-up 495 (182−658) 435 (143−586) 12-month follow-up 520 (261−709) 474 (225−620) p-value# <0.001 <0.001 6-min walking distance m Pre-operative 277±118 289±112 3-month follow-up 391±118 398±107 12-month follow-up 389±118 396±112 p-value# <0.001 <0.001 Data are presented as mean±sd or median (interquartile range), unless otherwise stated. mPAP: mean pulmonary arterial pressure; PVR: pulmonary vascular resistance; PaO2: arterial oxygen tension. Tests of interaction are as follows. mPAP: p=0.975; PVR: p=0.777; PaO2: p=0.317; modified Bruce exercise test: p=0.205; 6-min walking distance: p=0.962. #: versus pre-operative. Reproduced and modified from [24] with permission from the publisher.
- TABLE 2
Characteristics of an expert centre
Extensive experience with cardiothoracic surgery, including procedures requiring DHCA Excellent pulmonary and cardiac services Emphasis on pulmonary hypertension Expert diagnostic imaging Experienced multidisciplinary team comprising surgeons, radiologists, anaesthetists, intensivists, nurses, perfusionists, respiratory therapists and interventionalists, including specialists experienced in BPA DHCA: deep hypothermic circulatory arrest; BPA: balloon pulmonary angioplasty. Data from [12].
- TABLE 3
Proposed identification criteria of expert or high-quality centres
Level of expertise Criteria I 30-day or in-hospital mortality <5% II 30-day or in-hospital mortality <5% plus ≥50 procedures·year−1 III 30-day or in-hospital mortality <5% plus ≥50 procedures·year−1 plus ability to perform segmental endarterectomy/operate on distal disease
plus ability to provide PEA, BPA and medical therapyPEA: pulmonary endarterectomy; BPA: balloon pulmonary angioplasty.
- TABLE 4
The University of California, San Diego (UCSD) classification; a proposed new surgical classification of chronic thromboembolic pulmonary hypertension
Surgical level Location of thromboembolic disease 0 No evidence of thromboembolic disease I Starts in the main pulmonary arteries (patients with complete occlusion of one lung are classified as level IC) II Starts at the level of the lobar or intermediate pulmonary arteries III Starts at the level of segmental arteries only IV Starts at the subsegmental branches only Preliminary results (M. Madani, Division of Cardiovascular and Thoracic Surgery, University of California, San Diego, La Jolla, CA, USA; unpublished data).
Supplementary Material
A.M. D'Armini ERR-0111-2016_DArmini
D. Jenkins ERR-0111-2016_Jenkins
M. Madani ERR-0111-2016_Madani
E. Mayer ERR-0111-2016_Mayer
