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Vascular Surgery 2019
Journal of Vascular and Endovascular Therapy
ISSN: 2573-4482
Page 72
March 28-29, 2019
Rome, Italy
Vascular Surgery
4
th
Edition of World Congress & Exhibition on
J Vasc Endovasc Therapy 2019, Volume 4
DOI: 10.21767/2573-4482-C1-006
Ratio of pulmonary vascular resistance to occluded
pulmonary segments as an indicator of operability of
chronic thromboembolic pulmonary hypertension lesions
Gan Hui Li, Zhang Jian Qun
and
Feng L
The Anzhen Hospital, China
Objective:
The operability evaluation for pulmonary
thromboendarterectomy (PEA) in patients with chronic
thromboembolic pulmonary hypertension (CTEPH) is
always difficult. In this study, we aimed to identify a
better indicator of operability in patients with surgically
accessible CTEPH lesions.
Methods:
Two-hundred-eight patients with surgically
accessible CTEPH lesions who underwent PEA at Beijing
Anzhen Hospital from March 2001 to February 2014
were retrospectively reviewed. The occluded pulmonary
segments (OPS) were assessed by ventilation/perfusion
scintigraphy, pulmonary vascular resistance (PVR) was
measured by right heart catheterization and the PVR/
OPS ratio was calculated.
Results:
Seven (3.37%) early deaths occurred in the post-
PEA period, six late deaths occurred during the mean
follow-up period of 58.3±39.7 months; the five year
actuarial survival rate was 95.1%±3.5%. The PVR/OPS
ratios of early and late death after PEA were significantly
higher than those of early and late survival, respectively.
A PVR/OPS ratio of <100 dyne/s/cm-5/OPS had much
better specificity (88.7% vs. 69.2%) and sensitivity
(92.3% vs. 38.5%) than did PVR alone in the prediction
of early and late survival. The difference between the
two areas under their receiver operating characteristic
curves reached statistical significance (z test: Z=1.9917,
P=0.046).
Conclusion:
The PVR/OPS ratio is a better indicator of
operability for surgically accessible CTEPH than is PVR
alone. Patients with a PVR/OPS ratio of <100 dyne/s/
cm-5/OPS have better early and long-term outcomes
after PEA.
ganhuili@126.com