Larger pulmonary artery to ascending aorta ratios are associated with decreased survival of patients undergoing pulmonary endarterectomy.
AA, ascending aorta
BPA, balloon angioplasty
CT, computed tomography
CTE, chronic thromboembolic material
CTEPH, chronic thromboembolic pulmonary hypertension
DVT, deep venous thrombosis
PA to AA ratio
PA, pulmonary artery
PAP, pulmonary artery pressure
PE, pulmonary embolism
PEA, pulmonary endarterectomy
PH, pulmonary hypertension
PVR, pulmonary vascular resistance
RA, right atrium
WHO, World Health Organization
WU, Wood Units
chronic thromboembolic pulmonary hypertension
computed tomography
dPAP, diastolic pulmonary artery pressure
mPAP, mean pulmonary artery pressure
pulmonary endarterectomy
pulmonary hypertension
sPAP, systolic pulmonary artery pressure
Journal
JTCVS open
ISSN: 2666-2736
Titre abrégé: JTCVS Open
Pays: Netherlands
ID NLM: 101768541
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
received:
31
03
2021
accepted:
17
02
2022
entrez:
25
8
2022
pubmed:
26
8
2022
medline:
26
8
2022
Statut:
epublish
Résumé
The ratio of pulmonary artery (PA) and ascending aorta (AA) diameters has recently been shown to be a useful indicator for disease severity and predictor of outcome in patients with pulmonary hypertension and heart failure. This study aimed at evaluating the applicability of this ratio for perioperative risk assessment of patients with chronic thromboembolic pulmonary hypertension undergoing pulmonary endarterectomy. In this retrospective cohort study on 149 patients undergoing pulmonary endarterectomy between 2013 and 2020, the preoperative PA to AA ratio was analyzed on axial computed tomography. Variables of pulmonary hemodynamic status were assessed during preoperative right heart catheterization and postoperative Swan-Ganz catheter measurements. Perioperative survival was analyzed by Kaplan-Meier method and log-rank tests. Preoperative computed tomography measurements showed a median AA diameter of 31 mm (range, 19-47 mm), and a median PA diameter of 36 mm (range, 25-55 mm). The calculated median PA to AA ratio was 1.13 (range, 0.79-1.80). PA to AA ratio correlated positively with PA pressure (systolic, PA to AA ratio shows a correlation with other variables associated with pulmonary hypertension. In addition, patients with higher PA to AA ratios have lower survival probabilities after PEA. Further analysis of PA to AA ratio on the selection of chronic thromboembolic pulmonary hypertension for different treatment modalities-pulmonary endarterectomy, medical therapy, and or balloon pulmonary angioplasty-is warranted.
Identifiants
pubmed: 36004247
doi: 10.1016/j.xjon.2022.02.018
pii: S2666-2736(22)00082-1
pmc: PMC9390379
doi:
Types de publication
Journal Article
Langues
eng
Pagination
62-72Informations de copyright
© 2022 The Authors.
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