Effects of pulmonary thromboendarterectomy on right-sided echocardiographic parameters in patients with chronic thromboembolic pulmonary hypertension

Grace Casaclang-Verzosa, Robert B. McCully, Jae Kuen Oh, Fletcher A Jr. Miller, Christopher G A McGregor

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

OBJECTIVE: To determine the echocardiographic changes in the heart at 3 months and 1 year after pulmonary thromboendarterectomy (PTE) in patients with chronic thromboembolic pulmonary hypertension (CTEPH). PATIENTS AND METHODS: Thirty-two adult patients who underwent PTE for CTEPH at the Mayo Clinic in Rochester, Minn, from 1997 to 2003 were included in the study. All underwent transthoracic echocardiography before surgery. Follow-up echocardiography was performed within 3 months of surgery in 28 patients and 1 year postoperatively in 17 patients. The results were compared with baseline data. RESULTS: Within 3 months after PTE, the right ventricular end-diastolic area decreased from 38.4±12.8 cm2 to 32.5±10.4 cm2 (mean difference, 5.8±10.4 cm2; P=.02). The right ventricular end-systolic area decreased from 30.4±12.1 cm2 to 24.1±8.6 cm2 (mean difference, 6.3±10.1 cm2; P=.008). The right ventricular systolic pressure decreased significantly from 92.6±22.0 mm Hg to 55.0±19.8 mm Hg (mean difference, 40.0±24.8 mm Hg; P<.001). Tricuspid regurgitation (TR) Improved from a mean grade of 2.5±1.2 to 1.2±1.1 (mean difference, 1.5±1.0; P<.001). At 12 months, the right ventricular end-diastolic area, right ventricular end-systolic area, right ventricular systolic pressure, and TR also were significantly lower than baseline values. CONCLUSION: In patients with CTEPH who undergo PTE, echocardiographic measurements of right ventricular size, systolic pressure, and TR show significant improvement immediately after surgery, which is sustained for up to 1 year after surgery.

Original languageEnglish (US)
Pages (from-to)777-782
Number of pages6
JournalMayo Clinic Proceedings
Volume81
Issue number6
DOIs
StatePublished - 2006

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Endarterectomy
Pulmonary Hypertension
Tricuspid Valve Insufficiency
Lung
Ventricular Pressure
Blood Pressure
Echocardiography

Keywords

  • CI = confidence interval
  • CTEPH = chronic thromboembolic pulmonary hypertension
  • IVC = interior vena cava
  • LV = left ventricular
  • PAP = pulmonary artery pressure
  • PFO = patent foramen ovale
  • PTE = pulmonary thromboendarterectomy
  • RA = right atrial

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Effects of pulmonary thromboendarterectomy on right-sided echocardiographic parameters in patients with chronic thromboembolic pulmonary hypertension. / Casaclang-Verzosa, Grace; McCully, Robert B.; Oh, Jae Kuen; Miller, Fletcher A Jr.; McGregor, Christopher G A.

In: Mayo Clinic Proceedings, Vol. 81, No. 6, 2006, p. 777-782.

Research output: Contribution to journalArticle

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abstract = "OBJECTIVE: To determine the echocardiographic changes in the heart at 3 months and 1 year after pulmonary thromboendarterectomy (PTE) in patients with chronic thromboembolic pulmonary hypertension (CTEPH). PATIENTS AND METHODS: Thirty-two adult patients who underwent PTE for CTEPH at the Mayo Clinic in Rochester, Minn, from 1997 to 2003 were included in the study. All underwent transthoracic echocardiography before surgery. Follow-up echocardiography was performed within 3 months of surgery in 28 patients and 1 year postoperatively in 17 patients. The results were compared with baseline data. RESULTS: Within 3 months after PTE, the right ventricular end-diastolic area decreased from 38.4±12.8 cm2 to 32.5±10.4 cm2 (mean difference, 5.8±10.4 cm2; P=.02). The right ventricular end-systolic area decreased from 30.4±12.1 cm2 to 24.1±8.6 cm2 (mean difference, 6.3±10.1 cm2; P=.008). The right ventricular systolic pressure decreased significantly from 92.6±22.0 mm Hg to 55.0±19.8 mm Hg (mean difference, 40.0±24.8 mm Hg; P<.001). Tricuspid regurgitation (TR) Improved from a mean grade of 2.5±1.2 to 1.2±1.1 (mean difference, 1.5±1.0; P<.001). At 12 months, the right ventricular end-diastolic area, right ventricular end-systolic area, right ventricular systolic pressure, and TR also were significantly lower than baseline values. CONCLUSION: In patients with CTEPH who undergo PTE, echocardiographic measurements of right ventricular size, systolic pressure, and TR show significant improvement immediately after surgery, which is sustained for up to 1 year after surgery.",
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AU - McCully, Robert B.

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AU - Miller, Fletcher A Jr.

AU - McGregor, Christopher G A

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N2 - OBJECTIVE: To determine the echocardiographic changes in the heart at 3 months and 1 year after pulmonary thromboendarterectomy (PTE) in patients with chronic thromboembolic pulmonary hypertension (CTEPH). PATIENTS AND METHODS: Thirty-two adult patients who underwent PTE for CTEPH at the Mayo Clinic in Rochester, Minn, from 1997 to 2003 were included in the study. All underwent transthoracic echocardiography before surgery. Follow-up echocardiography was performed within 3 months of surgery in 28 patients and 1 year postoperatively in 17 patients. The results were compared with baseline data. RESULTS: Within 3 months after PTE, the right ventricular end-diastolic area decreased from 38.4±12.8 cm2 to 32.5±10.4 cm2 (mean difference, 5.8±10.4 cm2; P=.02). The right ventricular end-systolic area decreased from 30.4±12.1 cm2 to 24.1±8.6 cm2 (mean difference, 6.3±10.1 cm2; P=.008). The right ventricular systolic pressure decreased significantly from 92.6±22.0 mm Hg to 55.0±19.8 mm Hg (mean difference, 40.0±24.8 mm Hg; P<.001). Tricuspid regurgitation (TR) Improved from a mean grade of 2.5±1.2 to 1.2±1.1 (mean difference, 1.5±1.0; P<.001). At 12 months, the right ventricular end-diastolic area, right ventricular end-systolic area, right ventricular systolic pressure, and TR also were significantly lower than baseline values. CONCLUSION: In patients with CTEPH who undergo PTE, echocardiographic measurements of right ventricular size, systolic pressure, and TR show significant improvement immediately after surgery, which is sustained for up to 1 year after surgery.

AB - OBJECTIVE: To determine the echocardiographic changes in the heart at 3 months and 1 year after pulmonary thromboendarterectomy (PTE) in patients with chronic thromboembolic pulmonary hypertension (CTEPH). PATIENTS AND METHODS: Thirty-two adult patients who underwent PTE for CTEPH at the Mayo Clinic in Rochester, Minn, from 1997 to 2003 were included in the study. All underwent transthoracic echocardiography before surgery. Follow-up echocardiography was performed within 3 months of surgery in 28 patients and 1 year postoperatively in 17 patients. The results were compared with baseline data. RESULTS: Within 3 months after PTE, the right ventricular end-diastolic area decreased from 38.4±12.8 cm2 to 32.5±10.4 cm2 (mean difference, 5.8±10.4 cm2; P=.02). The right ventricular end-systolic area decreased from 30.4±12.1 cm2 to 24.1±8.6 cm2 (mean difference, 6.3±10.1 cm2; P=.008). The right ventricular systolic pressure decreased significantly from 92.6±22.0 mm Hg to 55.0±19.8 mm Hg (mean difference, 40.0±24.8 mm Hg; P<.001). Tricuspid regurgitation (TR) Improved from a mean grade of 2.5±1.2 to 1.2±1.1 (mean difference, 1.5±1.0; P<.001). At 12 months, the right ventricular end-diastolic area, right ventricular end-systolic area, right ventricular systolic pressure, and TR also were significantly lower than baseline values. CONCLUSION: In patients with CTEPH who undergo PTE, echocardiographic measurements of right ventricular size, systolic pressure, and TR show significant improvement immediately after surgery, which is sustained for up to 1 year after surgery.

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KW - LV = left ventricular

KW - PAP = pulmonary artery pressure

KW - PFO = patent foramen ovale

KW - PTE = pulmonary thromboendarterectomy

KW - RA = right atrial

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