Pulmonary Endarterectomy Improves Dyspnea by the Relief of Dead Space Ventilation

Plas, Mart N. van der; Reesink, Herre J.; Roos, C. M.; Steenwijk, Reindert P. van; Kloek, Jaap J.; Bresser, Paul

doi:10.1016/j.athoracsur.2009.08.001

Cited by 66 publications

(51 citation statements)

References 30 publications

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“…Four prospective studies were identified, 30,38,40,46) ; other studies were either clearly retrospective 6,15,22,25,29,35,42,44,47,48) or not specified. 21,26,33,43) Two studies presented results in a series of CTEPH patients treated surgically and medically 40,47) ; others included only series of surgically treated patients.…”

Section: Quality Of Evidencementioning

confidence: 99%

“…Only the most recent publications with the most complete data set from each institute were retained. As a result, 19 studies 6,15,21,22,25,26,29,30,33,35,36,38,40,[42][43][44][46][47][48] with a total number of 2729 patients were included for appraisal and data extraction ( Table 2).…”

Section: Quantity Of Evidencementioning

confidence: 99%

“…25,29,33,42) With the exception of one multicenter study from the UK 40) and another study from Germany including two centers, 36) other studies were from single tertiary referral centers. 6,15,21,22,25,26,29,30,33,35,38,[42][43][44][46][47][48] The largest series included 988 patients who underwent isolated PTE from 1997 to 2007 at UCSD. 6) Seven series had more than 100 patients, 6,15,25,38,40,44,47) five had between 50 and 100 patients (range 50-88), 22,29,30,35,43) and the other seven series had less than 50 patients each (range 23-41).…”

Section: Quality Of Evidencementioning

confidence: 99%

“…6,15,21,22,25,26,29,30,33,35,38,[42][43][44][46][47][48] The largest series included 988 patients who underwent isolated PTE from 1997 to 2007 at UCSD. 6) Seven series had more than 100 patients, 6,15,25,38,40,44,47) five had between 50 and 100 patients (range 50-88), 22,29,30,35,43) and the other seven series had less than 50 patients each (range 23-41). 21,26,33,36,42,46,48) The surgical technique was clearly described in one study, 6) and some modifications to Jamieson's technique were described in two studies.…”

Section: Quality Of Evidencementioning

confidence: 99%

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Pulmonary Thromboendarterectomy for Chronic Thromboembolic Pulmonary Hypertension : A Systematic Review

Rahnavardi

Yan

Cao

et al. 2011

ATCS

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Purpose: Pulmonary thromboendarterectomy (PTE) is a treatment option for patients with chronic thromboembolic pulmonary hypertension (CTEPH). The present systematic review was performed to assess the safety and efficacy of PTE for CTEPH. Methods: A systematic review was performed, and six electronic databases were searched for published studies from January 1999 to February 2010. All articles that presented morbidity and mortality data, survival data or preoperative and postoperative pulmonary hemodynamic indices were included. The primary outcome measures extracted were early morbidity and mortality, pulmonary hemodynamic and functional outcome indices prior to and after the operation, and survival data. Results: Of the 654 publications retrieved, 19 relevant papers (total number of 2729 patients) representing the most recent and complete data set from each institute, were included for appraisal and data extraction. No randomized controlled trials or matched comparative studies were identified. Thirty-day mortality ranged from 1.3% to 24% (median 8%). Residual pulmonary hypertension was reported in 11%-35% of patients after PTE. Pulmonary artery pressure and pulmonary vascular resistance significantly decreased after PTE in all studies. Before PTE, 60%-100% of patients were in NYHA functional class III or IV. This percentage decreased to 0%-21% after PTE. Five-year survival ranged from 74% to 89%. Conclusions: The current literature suggests that PTE for patients with CTEPH is associated with acceptable perioperative morbidity and mortality rates and improved hemodynamic indices and survival when viewed against the prognosis associated with historical controls using medical therapy.

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Section: Quality Of Evidencementioning

confidence: 99%

Section: Quantity Of Evidencementioning

confidence: 99%

Section: Quality Of Evidencementioning

confidence: 99%

Section: Quality Of Evidencementioning

confidence: 99%

See 2 more Smart Citations

Pulmonary Thromboendarterectomy for Chronic Thromboembolic Pulmonary Hypertension : A Systematic Review

Rahnavardi

Yan

Cao

et al. 2011

ATCS

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“…The problem concerning the nature and the function of the dead space is of basic importance for the full comprehension of the respiratory physiology and pathophysiology [12][13][14][15][16][17][18]. Extended studies [19][20][21][22][23] on the concept of dead space have been made in the last half-century.…”

Section: Introductionmentioning

confidence: 99%

The Effect of mechanical resistive loading on optimal respiratory signals and breathing patterns under added dead space and CO2 breathing

Lin

Chang

2016

MATEC Web Conf.

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Abstract. Current study aims to investigate how the respiratory resistive loading affects the behaviour of the optimal chemical-mechanical respiratory control model, the respiratory signals and breathing pattern are optimized under external dead space loading and CO2 breathing. The respiratory control was modelled to include a neuro-muscular drive as the control output to derive the waveshapes of instantaneous airflow, lung volume profiles, and breathing pattern, including total/alveolar ventilation, breathing frequency, tidal volume, inspiratory/expiratory duration, duty cycle, and arterial CO2 pressure. The simulations were performed under various respiratory resistive loads, including no load, inspiratory resistive load, expiratory resistive load, and continuous resistive load. The dead space measurement was described with Gray's derivation, and simulation results were studied and compared with experimental findings.

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Chronic Thromboembolic Pulmonary Hypertension

Papamatheakis

Auger

2017

Handbook of Venous Thromboembolism

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The pulmonary hypertension (PH) and right heart dysfunction that results from chronic thromboembolic involvement of the pulmonary vascular bed is potentially curable with surgical endarterectomy. Over the past several decades, growing clinical experience has brought about increased recognition of this treatable form of PH. Moreover, advances in cardiothoracic surgical techniques have given an increasing number of patients with chronic thromboembolic PH (CTEPH) a surgical remedy with decreasing perioperative morbidity and mortality risks. The availability of pulmonary hypertensive-specific medical therapy for CTEPH patients with surgically inaccessible disease also has been a positive therapeutic advance over the past several years. However, despite this progress, chronic thromboembolic disease as a sequela of acute pulmonary emboli continues to be underappreciated. Furthermore, even if CTEPH has been appropriately diagnosed, misinterpretation of diagnostic information may lead to the inappropriate exclusion of patients from surgical consideration. This may result in the prescription of pulmonary hypertensive medical therapy in CTEPH patients with potentially surgically correctable disease. This difficulty arises from a lack of objective criteria as to what constitutes surgical chronic thromboembolic disease, which primarily is a result of the variability in surgical experience in specialty centers in the United States. Consequently, clinicians must be wary about using pulmonary hypertensive medications in CTEPH patients. Before prescription, it is important to exclude patients from surgical consideration by consulting a specialized center with expertise in this discipline.

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Pulmonary Endarterectomy Improves Dyspnea by the Relief of Dead Space Ventilation

Cited by 66 publications

References 30 publications

Pulmonary Thromboendarterectomy for Chronic Thromboembolic Pulmonary Hypertension : A Systematic Review

Pulmonary Thromboendarterectomy for Chronic Thromboembolic Pulmonary Hypertension : A Systematic Review

The Effect of mechanical resistive loading on optimal respiratory signals and breathing patterns under added dead space and CO2 breathing

Chronic Thromboembolic Pulmonary Hypertension

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