Residual pulmonary hypertension after pulmonary endarterectomy: A meta-analysis
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11110%2F18%3A10378553" target="_blank" >RIV/00216208:11110/18:10378553 - isvavai.cz</a>
Alternative codes found
RIV/00064165:_____/18:10378553
Result on the web
<a href="https://doi.org/10.1016/j.jtcvs.2018.04.110" target="_blank" >https://doi.org/10.1016/j.jtcvs.2018.04.110</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1016/j.jtcvs.2018.04.110" target="_blank" >10.1016/j.jtcvs.2018.04.110</a>
Alternative languages
Result language
angličtina
Original language name
Residual pulmonary hypertension after pulmonary endarterectomy: A meta-analysis
Original language description
Objective: Chronic thromboembolic pulmonary hypertension is surgically treated through pulmonary endarterectomy. Although pulmonary endarterectomy is the treatment of choice for chronic thromboembolic pulmonary hypertension in terms of both functional outcomes and survival, many patients experience persistent pulmonary hypertension after pulmonary endarterectomy. The study objective was to calculate the pooled estimates of outcomes after pulmonary endarterectomy, including persistent pulmonary hypertension. Methods: Meta-analyses were conducted on published studies reporting residual/persistent/recurrent pulmonary hypertension in 4868 patients with chronic thromboembolic pulmonary hypertension after pulmonary endarterectomy. The rate of persistent pulmonary hypertension and change in mean pulmonary artery pressure, pulmonary vascular resistance, and 6-minute walk distance after pulmonary endarterectomy were outcomes of interest. Results: Twenty-five percent of patients with chronic thromboembolic pulmonary hypertension were diagnosed with persistent pulmonary hypertension after pulmonary endarterectomy. Pulmonary endarterectomy reduced mean pulmonary artery pressure and pulmonary vascular resistance by approximately 21 mm Hg (standardized mean difference, 1.75; 95% confidence interval, -1.62 to 1.88; P < .00001) and 561 dyn.s/cm(5) (standardized mean difference, 1.64; 95% confidence interval, -1.58 to 1.70; P < .00001), respectively. Conversely, 6-minute walk distance increased by 96m (standardized mean difference, 0.83; 95% confidence interval, -0.91 to -0.76; P < .00001) after pulmonary endarterectomy. Conclusions: Pulmonary endarterectomy is the gold standard treatment for chronic thromboembolic pulmonary hypertension and provides immediate correction of hemodynamic parameters in most patients. However, in up to one quarter of operable cases, pulmonary hypertension persists after surgery. In those patients with persistent pulmonary hypertension, continued medical management with newer agents may be required to improve pulmonary hemodynamics and, therefore, patient outcomes.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30201 - Cardiac and Cardiovascular systems
Result continuities
Project
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Continuities
S - Specificky vyzkum na vysokych skolach
Others
Publication year
2018
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
The Journal of Thoracic and Cardiovascular Surgery
ISSN
0022-5223
e-ISSN
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Volume of the periodical
156
Issue of the periodical within the volume
3
Country of publishing house
US - UNITED STATES
Number of pages
13
Pages from-to
1275-1287
UT code for WoS article
000441556000094
EID of the result in the Scopus database
2-s2.0-85048348852