Life expectancy after pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension: a Swedish single-center study.
Janica KallonenNatalie GlaserFredrik BredinMatthias CorbascioUlrik SartipyPublished in: Pulmonary circulation (2020)
Pulmonary endarterectomy is the guideline recommended treatment for chronic thromboembolic pulmonary hypertension, in addition to life-long anticoagulation therapy. The aim was to analyze long-term relative survival after pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension. We included all patients who underwent pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension at Karolinska University Hospital between 1997 and 2018 (n = 100). We obtained baseline characteristics and vital status from patient charts and national health-data registers. The expected survival from the general Swedish population matched by age, sex, and year of surgery was obtained from the Human Mortality Database. The relative survival was used as an estimate of cause-specific mortality. The mean age of the patients was 62 years and 39% were women. Most patients were severely symptomatic (95% in New York Heart Association functional class III-IV), and mean preoperative systolic/diastolic (mean) pulmonary artery pressure was 78/27 (45) mmHg. The mean and maximum follow-up time was 7.2 and 22.1 years, respectively. Early (30-day) mortality was 7%. The 15-year observed, expected, and relative survival was 55% (95% confidence interval, 40%-68%), 71%, and 77% (95% confidence interval, 56%-95%), respectively. The 15-year relative survival conditional on 30-day survival was 83% (95% confidence interval, 60%-100%). Although the life expectancy following pulmonary endarterectomy was shorter compared to the general population, the difference was small in those who survived the operation and the early postoperative period. Patients with chronic thromboembolic pulmonary hypertension who are surgical candidates should undergo pulmonary endarterectomy to improve prognosis.
Keyphrases
- pulmonary hypertension
- pulmonary artery
- pulmonary arterial hypertension
- end stage renal disease
- ejection fraction
- newly diagnosed
- chronic kidney disease
- peritoneal dialysis
- coronary artery bypass grafting
- minimally invasive
- cardiovascular events
- blood pressure
- heart failure
- patients undergoing
- skeletal muscle
- patient reported outcomes
- mesenchymal stem cells
- metabolic syndrome
- machine learning
- stem cells
- coronary artery disease
- venous thromboembolism
- insulin resistance
- risk factors
- electronic health record
- deep learning
- percutaneous coronary intervention
- acute coronary syndrome
- replacement therapy
- artificial intelligence
- drug induced
- smoking cessation