초록접수 현황
| 20F-101 | 구연 발표 |
The Hybrid approach for the treatment of chronic thromboembolic pulmonary hypertension.
Ilkun Park, Suryeun Chung, Yang Hyun Cho, Dong Seop Jeong, Ji-Hyuk Yang, Kiick Sung, Wook Sung Kim, Tae-Gook Jun
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine
Purpose : Pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension(CTEPH) has good postoperative results with improved hemodynamics, but some patients have remaining lesions and symptoms even after successful operation. We tried to compare outcomes of hybrid approach for CTEPH with conventional approach.
Methods : This study is a single-center retrospective cohort study. From 1997 January to 2020 December, 78 patients with CTEPH underwent pulmonary endarterectomy. From 2014, hybrid approach with routine pulmonary angiography and angioplasty in selected postoperative patients were adopted. The primary endpoint is major cardiovascular adverse event (MACE), composed of readmission for heart failure, reoperation for CTEPH, and death.
Results : 46 patients (58%) were considered Hybrid group. Preoperative ejection fraction (61.5% vs. 64.7%, P=0.111) and tricuspid annular plane systolic excursion (16.5mm vs. 15.9mm, P=0.739) were similar in both groups. Hybrid group had better 6-year MACE (86.5% vs. 56.3%, P=0.023), more patients with postoperative balloon angioplasty (45.7% vs. 12.5%, P=0.005), and shorter median time to BPA (0.58 years vs. 10.17 years) than conventional group. Post-angioplasty pulmonary vascular resistance (2.15 WU vs. 2.95 WU, P=0.009) was lower than postoperative PVR and post-angioplasty total distance walked in the 6-min walk test (490 meter vs. 354 meter, P=0.027) was longer than preoperative value in the Hybrid group.
Conclusion : Hybrid approach for CTEPH had higher composed rate of freedom from readmission for heart failure, reoperation for CTEPH, and death at 6 years. Postoperative balloon angioplasty reduced pulmonary vascular resistance and enhanced total distance in the 6-min walk test in selected patients. Hybrid approach is recommended for management of CTEPH.
Methods : This study is a single-center retrospective cohort study. From 1997 January to 2020 December, 78 patients with CTEPH underwent pulmonary endarterectomy. From 2014, hybrid approach with routine pulmonary angiography and angioplasty in selected postoperative patients were adopted. The primary endpoint is major cardiovascular adverse event (MACE), composed of readmission for heart failure, reoperation for CTEPH, and death.
Results : 46 patients (58%) were considered Hybrid group. Preoperative ejection fraction (61.5% vs. 64.7%, P=0.111) and tricuspid annular plane systolic excursion (16.5mm vs. 15.9mm, P=0.739) were similar in both groups. Hybrid group had better 6-year MACE (86.5% vs. 56.3%, P=0.023), more patients with postoperative balloon angioplasty (45.7% vs. 12.5%, P=0.005), and shorter median time to BPA (0.58 years vs. 10.17 years) than conventional group. Post-angioplasty pulmonary vascular resistance (2.15 WU vs. 2.95 WU, P=0.009) was lower than postoperative PVR and post-angioplasty total distance walked in the 6-min walk test (490 meter vs. 354 meter, P=0.027) was longer than preoperative value in the Hybrid group.
Conclusion : Hybrid approach for CTEPH had higher composed rate of freedom from readmission for heart failure, reoperation for CTEPH, and death at 6 years. Postoperative balloon angioplasty reduced pulmonary vascular resistance and enhanced total distance in the 6-min walk test in selected patients. Hybrid approach is recommended for management of CTEPH.
첨부파일 : CTEPH_figure.pptx
책임저자: Dong Seop Jeong
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine
발표자: Ilkun Park, E-mail : thestyner@hotmail.com