Pulmonary Thromboendarterectomy in Portugal: Initial Experience

Detalhes bibliográficos
Autor(a) principal: Fragata, J
Data de Publicação: 2020
Outros Autores: Telles Antunes, H
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10400.17/3530
Resumo: Introduction: Surgical treatment for chronic thromboembolic pulmonary hypertension (CTEPH) is challenging. Most Portuguese patients with CTEPH have been referred to foreign institutions for treatment, with significant social and economic costs. To meet this emerging need, the cardiothoracic surgery department of Hospital de Santa Marta, Lisbon, has developed a dedicated program for pulmonary thromboendarterectomy (PTE). We hereby present the results for the first 19 patients treated. Methods: We conducted a retrospective analysis of all 19 patients who underwent PTE at Hospital de Santa Marta between 2008 and April 2019. Results: Since 2008, a total of 19 patients have undergone PTE in our department. The procedure was performed with good outcomes in both survival and functional recovery. At the very beginning of the series two patients died perioperatively, before all the team underwent formal training at the Royal Papworth Hospital, UK, with no early deaths since. Postoperative complications were similar to other published series. During 11 years of follow-up, there were three late deaths, all in patients with residual pulmonary arterial hypertension. At the latest follow-up (October 2019), all surviving patients showed significant functional recovery, all in NYHA class I or II, with only one patient on vasodilator therapy with sildenafil (the first in the series, operated in 2008). Conclusions: PTE is a demanding procedure, in which outcomes are related to volume and accumulated experience, however it can be performed safely and with reproducible results by a properly prepared dedicated team with a well-controlled learning curve. More patients and multidisciplinary experience will be needed to further improve and streamline results.
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spelling Pulmonary Thromboendarterectomy in Portugal: Initial ExperienceTromboendarterectomia Pulmonar em Portugal: Experiência InicialHSM CCTChronic Thromboembolic Pulmonary HypertensionPulmonary ThromboendarterectomySingle-Center Report ResultsCardiothoracic SurgeryPulmonary HypertensionTreatmentIntroduction: Surgical treatment for chronic thromboembolic pulmonary hypertension (CTEPH) is challenging. Most Portuguese patients with CTEPH have been referred to foreign institutions for treatment, with significant social and economic costs. To meet this emerging need, the cardiothoracic surgery department of Hospital de Santa Marta, Lisbon, has developed a dedicated program for pulmonary thromboendarterectomy (PTE). We hereby present the results for the first 19 patients treated. Methods: We conducted a retrospective analysis of all 19 patients who underwent PTE at Hospital de Santa Marta between 2008 and April 2019. Results: Since 2008, a total of 19 patients have undergone PTE in our department. The procedure was performed with good outcomes in both survival and functional recovery. At the very beginning of the series two patients died perioperatively, before all the team underwent formal training at the Royal Papworth Hospital, UK, with no early deaths since. Postoperative complications were similar to other published series. During 11 years of follow-up, there were three late deaths, all in patients with residual pulmonary arterial hypertension. At the latest follow-up (October 2019), all surviving patients showed significant functional recovery, all in NYHA class I or II, with only one patient on vasodilator therapy with sildenafil (the first in the series, operated in 2008). Conclusions: PTE is a demanding procedure, in which outcomes are related to volume and accumulated experience, however it can be performed safely and with reproducible results by a properly prepared dedicated team with a well-controlled learning curve. More patients and multidisciplinary experience will be needed to further improve and streamline results.Elsevier EspañaRepositório do Centro Hospitalar Universitário de Lisboa Central, EPEFragata, JTelles Antunes, H2020-12-15T14:19:19Z2020-092020-09-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.17/3530engRev Port Cardiol. 2020 Sep;39(9):505-512.10.1016/j.repc.2020.05.006info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-03-10T09:43:27Zoai:repositorio.chlc.min-saude.pt:10400.17/3530Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T17:20:50.478131Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Pulmonary Thromboendarterectomy in Portugal: Initial Experience
Tromboendarterectomia Pulmonar em Portugal: Experiência Inicial
title Pulmonary Thromboendarterectomy in Portugal: Initial Experience
spellingShingle Pulmonary Thromboendarterectomy in Portugal: Initial Experience
Fragata, J
HSM CCT
Chronic Thromboembolic Pulmonary Hypertension
Pulmonary Thromboendarterectomy
Single-Center Report Results
Cardiothoracic Surgery
Pulmonary Hypertension
Treatment
title_short Pulmonary Thromboendarterectomy in Portugal: Initial Experience
title_full Pulmonary Thromboendarterectomy in Portugal: Initial Experience
title_fullStr Pulmonary Thromboendarterectomy in Portugal: Initial Experience
title_full_unstemmed Pulmonary Thromboendarterectomy in Portugal: Initial Experience
title_sort Pulmonary Thromboendarterectomy in Portugal: Initial Experience
author Fragata, J
author_facet Fragata, J
Telles Antunes, H
author_role author
author2 Telles Antunes, H
author2_role author
dc.contributor.none.fl_str_mv Repositório do Centro Hospitalar Universitário de Lisboa Central, EPE
dc.contributor.author.fl_str_mv Fragata, J
Telles Antunes, H
dc.subject.por.fl_str_mv HSM CCT
Chronic Thromboembolic Pulmonary Hypertension
Pulmonary Thromboendarterectomy
Single-Center Report Results
Cardiothoracic Surgery
Pulmonary Hypertension
Treatment
topic HSM CCT
Chronic Thromboembolic Pulmonary Hypertension
Pulmonary Thromboendarterectomy
Single-Center Report Results
Cardiothoracic Surgery
Pulmonary Hypertension
Treatment
description Introduction: Surgical treatment for chronic thromboembolic pulmonary hypertension (CTEPH) is challenging. Most Portuguese patients with CTEPH have been referred to foreign institutions for treatment, with significant social and economic costs. To meet this emerging need, the cardiothoracic surgery department of Hospital de Santa Marta, Lisbon, has developed a dedicated program for pulmonary thromboendarterectomy (PTE). We hereby present the results for the first 19 patients treated. Methods: We conducted a retrospective analysis of all 19 patients who underwent PTE at Hospital de Santa Marta between 2008 and April 2019. Results: Since 2008, a total of 19 patients have undergone PTE in our department. The procedure was performed with good outcomes in both survival and functional recovery. At the very beginning of the series two patients died perioperatively, before all the team underwent formal training at the Royal Papworth Hospital, UK, with no early deaths since. Postoperative complications were similar to other published series. During 11 years of follow-up, there were three late deaths, all in patients with residual pulmonary arterial hypertension. At the latest follow-up (October 2019), all surviving patients showed significant functional recovery, all in NYHA class I or II, with only one patient on vasodilator therapy with sildenafil (the first in the series, operated in 2008). Conclusions: PTE is a demanding procedure, in which outcomes are related to volume and accumulated experience, however it can be performed safely and with reproducible results by a properly prepared dedicated team with a well-controlled learning curve. More patients and multidisciplinary experience will be needed to further improve and streamline results.
publishDate 2020
dc.date.none.fl_str_mv 2020-12-15T14:19:19Z
2020-09
2020-09-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10400.17/3530
url http://hdl.handle.net/10400.17/3530
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Rev Port Cardiol. 2020 Sep;39(9):505-512.
10.1016/j.repc.2020.05.006
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eu_rights_str_mv openAccess
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dc.publisher.none.fl_str_mv Elsevier España
publisher.none.fl_str_mv Elsevier España
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
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