Operative and Functional Outcome After Pulmonary Endarterectomy for Advanced XXXX .

@entity1 @entity66 @entity26 @entity120 @entity3587
AIM: To evaluate the midterm hemodynamic and functional outcome of pulmonary endarterectomy ( @entity3587 ) for @entity1 with advanced @entity120 ( @entity120 ). METHODS: Thirty-eight consecutive @entity1 underwent @entity3587 for @entity120 from May 2004 to March 2012. All @entity1 were followed prospectively at six months postoperatively and annually thereafter. Each @entity1 underwent serial cardiopulmonary exercise testing (CPET) and transthoracic echocardiography, and were followed for up to four years. RESULTS: Overall, 31.5% (12/38) of @entity1 had Jamieson class II disease while 65.8% (25/38) had @entity66 . There were three in-hospital mortalities (7.9%), all of which had baseline pulmonary vasculature resistance (PVR) greater than 1400   dynes-sec-cm(-5) . Preoperative PVR and mean pulmonary artery pressure were 1209        723   dynes-sec-cm(-5) and 50        14   mmHg, respectively, signifying a high-risk operative group. Ninety-seven percent of @entity1 were in NYHA class III or IV preoperatively. At median follow-up of 29 months 89.5% (17/19) of @entity1 were in NYHA class I or II. CPET revealed a progressive increase in peak @entity26 consumption from 16.5        4.1   ml/kg/min at first follow-up, to a plateau of 20.2        5.6   ml/kg/min (p   =   0.032) at two years. CONCLUSIONS: CPET can be used to quantify progress in functional capacity post- @entity120 , although improvements in peak @entity26 consumption plateau at two years.
