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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 &lt; .00001) and 561 dyn.s/cm(5) (standardized mean difference, 1.64; 95% confidence interval, -1.58 to 1.70; P &lt; .00001), respectively. Conversely, 6-minute walk distance increased by 96m (standardized mean difference, 0.83; 95% confidence interval, -0.91 to -0.76; P &lt; .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

  • Czech description

Classification

  • Type

    J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database

  • CEP classification

  • OECD FORD branch

    30201 - Cardiac and Cardiovascular systems

Result continuities

  • Project

  • 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

  • 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