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Cross-Border European Cooperation in Pulmonary Endarterectomy
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A6339 - Cross-Border European Cooperation in Pulmonary Endarterectomy
Author Block: K. Karlocai1, G. Csosza1, Z. Lazar1, I. M. Lang2, B. Moser2, S. Taghavi2, W. Klepetko2; 1PAH center / Pulmonology, Semmelweis University, Budapest, Hungary, 2Medical University Vienna, Vienna, Austria.
Objectives: Chronic thromboembolic pulmonary hypertension is a rare disease. The intervention of choice is pulmonary endarterectomy (PEA) which needs the highest surgical skills. In deep hypothermia, the essence of the operation is limited to 20-40 minutes whereas a wrong move can result in incurable pulmonary artery perforation. Appropriate practice for surgery can only be obtained in large volume centers. Our evaluation center works in close cooperation with a nearby high volume thoracic surgery center, the Vienna University. The PAH board brings decision for acceptance of patients on the basis of electronically sent patient history, CT and pulmonary angiography, VQ scan and right heart catheterization. The aim of the study was to overview the results of PEA in the Hungarian subgroup.
Methods: All patients with Hungarian citizenship undergoing pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension in Vienna between 2005 and 2017 were retrospectively analyzed.
Results: 35 patients entered the study, mean age was 51.4 ± 13.3 years, males 61%, females 39%. One third of the patients had previous acute pulmonary embolism in the history. The postoperative mean pulmonary pressures were significantly lower (30,7 mmHg ± 14,9 mmHg) than the preoperative ones (50,9 mmHg ± 13,0 mmHg). There were four deaths resulting in total favorable medial survival (1-, 3- and 5-year survival 97%, 92%, 89%, respectively). Functional class and quality of life increased significantly. These data are comparable, non-inferior with the results of all patients operated in Vienna.
Conclusions: Cross-border cooperation in highly sophisticated chest surgery like pulmonary endarterectomy is feasible, results in excellent survival and good quality of life. Patients of a small country, like Hungary without own PEA program can enjoy the advantages of a near high volume center. This needs accurate organization and mutual discussions. The higher cost of surgery will return in good surgical results.
Author Block: K. Karlocai1, G. Csosza1, Z. Lazar1, I. M. Lang2, B. Moser2, S. Taghavi2, W. Klepetko2; 1PAH center / Pulmonology, Semmelweis University, Budapest, Hungary, 2Medical University Vienna, Vienna, Austria.
Objectives: Chronic thromboembolic pulmonary hypertension is a rare disease. The intervention of choice is pulmonary endarterectomy (PEA) which needs the highest surgical skills. In deep hypothermia, the essence of the operation is limited to 20-40 minutes whereas a wrong move can result in incurable pulmonary artery perforation. Appropriate practice for surgery can only be obtained in large volume centers. Our evaluation center works in close cooperation with a nearby high volume thoracic surgery center, the Vienna University. The PAH board brings decision for acceptance of patients on the basis of electronically sent patient history, CT and pulmonary angiography, VQ scan and right heart catheterization. The aim of the study was to overview the results of PEA in the Hungarian subgroup.
Methods: All patients with Hungarian citizenship undergoing pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension in Vienna between 2005 and 2017 were retrospectively analyzed.
Results: 35 patients entered the study, mean age was 51.4 ± 13.3 years, males 61%, females 39%. One third of the patients had previous acute pulmonary embolism in the history. The postoperative mean pulmonary pressures were significantly lower (30,7 mmHg ± 14,9 mmHg) than the preoperative ones (50,9 mmHg ± 13,0 mmHg). There were four deaths resulting in total favorable medial survival (1-, 3- and 5-year survival 97%, 92%, 89%, respectively). Functional class and quality of life increased significantly. These data are comparable, non-inferior with the results of all patients operated in Vienna.
Conclusions: Cross-border cooperation in highly sophisticated chest surgery like pulmonary endarterectomy is feasible, results in excellent survival and good quality of life. Patients of a small country, like Hungary without own PEA program can enjoy the advantages of a near high volume center. This needs accurate organization and mutual discussions. The higher cost of surgery will return in good surgical results.
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