Long-term outcome after pulmonary thromboendarterectomy

This study evaluated long-term outcome of pulmonary thromboendarterectomy ( PTE) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) . Survival, functional status, quality of life, health care utilization, an d relationships between these parameters and postoperative pulmonary hemody namics were assessed. Questionnaires were mailed to 420 patients who were m ore than 1 yr post-PTE; 308 responded (mean age, 56 yr [range, 19-89 yr]; m ean years since PTE, 3.3 [range, 1-16]). Survival after PTE was 75% at > 6 yr. After surgery, symptoms were markedly reduced. Median distance walked w as 5,280 ft; 56 patients could walk "indefinitely." Of the working populati on, 62% of patients unemployed before PTE returned to work. Post-PTE patien ts scored several quality of life components of the Rand SF-36 slightly low er than reported normals but significantly higher than did pre-PTE patients . Ten percent of patients used oxygen. Ninety-three percent were in NYHA Cl ass I or II. Disease-related hospitalizations/ER visits were minimal. A rel ationship was shown between 48 h postoperative pulmonary vascular resistanc e (PVR) and walking and stair-climbing ability, NYHA class, dyspnea scores, and the physical function and general health quality of life components. T hese data indicate that PTE offers most CTEPH patients substantial improvem ent in survival, function, and quality of life, with minimal disease-relate d health care utilization.