RESEARCH ARTICLE
Factors predicting outcome after pulmonary endarterectomy Ce´cile Tromeur1,2,3☯*, Xavier Jaïs4,5,6☯, Olaf Mercier4,6,7, Francis Couturaud1,2,3, David Montani4,5,6, Laurent Savale4,5,6, Mitja Jevnikar4,5,6, Jason Weatherald4,5,6,8, Olivier Sitbon4,5,6, Florence Parent4,5,6, Dominique Fabre4,6,7, Sacha Mussot4,6,7, Philippe Dartevelle4,6,7, Marc Humbert4,5,6, Ge´rald Simonneau4,5,6, Elie Fadel4,6,7
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1 European Brittany University, Brest, France, 2 Department of Internal Medicine and Chest Diseases, University Hospital Centre La Cavale Blanche, Brest, France, 3 Groupe d’Etude de la Thrombose de Bretagne Occidentale (GETBO), EA 3878, CIC INSERM 1412, Brest, France, 4 Univ Paris-Sud, Faculte´ de Me´decine, Universite´ Paris-Saclay, Le Kremlin-Bicêtre, France, 5 AP-HP, Service de Pneumologie, Centre de Re´fe´rence de l’Hypertension Pulmonaire, Hoˆpital Bicêtre, Le Kremlin-Bicêtre, France, 6 INSERM UMR_S 999, Hoˆpital Marie Lannelongue, Le Plessis Robinson, France, 7 Service de Chirurgie Thoracique et Vasculaire et de Transplantation Cardiopulmonaire, Hoˆpital Marie Lannelongue, Le Plessis Robinson, France, 8 Department of Medicine, Division of Respirology, University of Calgary, Calgary, Alberta, Canada ☯ These authors contributed equally to this work. *
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Abstract OPEN ACCESS Citation: Tromeur C, Jaïs X, Mercier O, Couturaud F, Montani D, Savale L, et al. (2018) Factors predicting outcome after pulmonary endarterectomy. PLoS ONE 13(6): e0198198. https://doi.org/10.1371/journal.pone.0198198
Objective Few studies have reported predictive factors of outcome after pulmonary endarterectomy (PEA) in chronic thromboembolic pulmonary hypertension. The purpose of this study was to determine factors influencing mortality and predictors of hemodynamic improvement after PEA.
Editor: Vinicio A. de Jesus Perez, Stanford University, UNITED STATES Received: February 21, 2018
Methods
Accepted: May 15, 2018
A total of 383 consecutive patients who underwent PEA between January 2005 and December 2009 were retrospectively reviewed. Among them, 150 were fully reevaluated 7.5±1 months after PEA by NYHA class, 6–minute walk distance (6MWD), percentage of predicted carbon monoxide transfer factor (TLCO) and right heart catheterisation.
Published: June 21, 2018 Copyright: © 2018 Tromeur et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All relevant data are within the paper and its Supporting Information files. Funding: The authors received no specific funding for this work. Competing interests: The authors have declared that no competing interests exist.
Results Mortality rates at 1 month, 1 year and 3 years were 2.8%, 6.9% and 7.5%, respectively. Preoperative pulmonary vascular resistance (PVR) independently predicted 1-month, 1- and 3year mortality and age predicted mortality at 1 year and 3 years. Significant improvement in NYHA class and 6MWD were observed and PVR decreased from 773±353 to 307±221 dyn. sec.cm-5 (p
