PMID- 29927944 OWN - NLM STAT- MEDLINE DCOM- 20181211 LR - 20181211 IS - 1932-6203 (Electronic) IS - 1932-6203 (Linking) VI - 13 IP - 6 DP - 2018 TI - Factors predicting outcome after pulmonary endarterectomy. PG - e0198198 LID - 10.1371/journal.pone.0198198 [doi] LID - e0198198 AB - OBJECTIVE: Few studies have reported predictive factors of outcome after pulmonary endarterectomy (PEA) in chronic thromboembolic pulmonary hypertension. The purpose of this study was to determine factors influencing mortality and predictors of hemodynamic improvement after PEA. METHODS: A total of 383 consecutive patients who underwent PEA between January 2005 and December 2009 were retrospectively reviewed. Among them, 150 were fully reevaluated 7.5+/-1 months after PEA by NYHA class, 6-minute walk distance (6MWD), percentage of predicted carbon monoxide transfer factor (TLCO) and right heart catheterisation. RESULTS: Mortality rates at 1 month, 1 year and 3 years were 2.8%, 6.9% and 7.5%, respectively. Preoperative pulmonary vascular resistance (PVR) independently predicted 1-month, 1- and 3-year mortality and age predicted mortality at 1 year and 3 years. Significant improvement in NYHA class and 6MWD were observed and PVR decreased from 773+/-353 to 307+/-221 dyn.sec.cm-5 (p<0.001). In 96 patients (64%), PVR decreased by at least 50% and/or was reduced to lower than 250 dyn.sec.cm-5. Preoperative cardiac output (CO) and TLCO predicted hemodynamic improvement. CONCLUSION: PEA is associated with an excellent long-term survival and a marked improvement in clinical status and hemodynamics. Some preoperative factors including PVR, CO and TLCO can predict postoperative outcomes. FAU - Tromeur, Cecile AU - Tromeur C AUID- ORCID: 0000-0001-9161-7521 AD - European Brittany University, Brest, France. AD - Department of Internal Medicine and Chest Diseases, University Hospital Centre La Cavale Blanche, Brest, France. AD - Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), EA 3878, CIC INSERM 1412, Brest, France. FAU - Jais, Xavier AU - Jais X AD - Univ Paris-Sud, Faculte de Medecine, Universite Paris-Saclay, Le Kremlin-Bicetre, France. AD - AP-HP, Service de Pneumologie, Centre de Reference de l'Hypertension Pulmonaire, Hopital Bicetre, Le Kremlin-Bicetre, France. AD - INSERM UMR_S 999, Hopital Marie Lannelongue, Le Plessis Robinson, France. FAU - Mercier, Olaf AU - Mercier O AD - Univ Paris-Sud, Faculte de Medecine, Universite Paris-Saclay, Le Kremlin-Bicetre, France. AD - INSERM UMR_S 999, Hopital Marie Lannelongue, Le Plessis Robinson, France. AD - Service de Chirurgie Thoracique et Vasculaire et de Transplantation Cardiopulmonaire, Hopital Marie Lannelongue, Le Plessis Robinson, France. FAU - Couturaud, Francis AU - Couturaud F AD - European Brittany University, Brest, France. AD - Department of Internal Medicine and Chest Diseases, University Hospital Centre La Cavale Blanche, Brest, France. AD - Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), EA 3878, CIC INSERM 1412, Brest, France. FAU - Montani, David AU - Montani D AUID- ORCID: 0000-0002-9358-6922 AD - Univ Paris-Sud, Faculte de Medecine, Universite Paris-Saclay, Le Kremlin-Bicetre, France. AD - AP-HP, Service de Pneumologie, Centre de Reference de l'Hypertension Pulmonaire, Hopital Bicetre, Le Kremlin-Bicetre, France. AD - INSERM UMR_S 999, Hopital Marie Lannelongue, Le Plessis Robinson, France. FAU - Savale, Laurent AU - Savale L AD - Univ Paris-Sud, Faculte de Medecine, Universite Paris-Saclay, Le Kremlin-Bicetre, France. AD - AP-HP, Service de Pneumologie, Centre de Reference de l'Hypertension Pulmonaire, Hopital Bicetre, Le Kremlin-Bicetre, France. AD - INSERM UMR_S 999, Hopital Marie Lannelongue, Le Plessis Robinson, France. FAU - Jevnikar, Mitja AU - Jevnikar M AD - Univ Paris-Sud, Faculte de Medecine, Universite Paris-Saclay, Le Kremlin-Bicetre, France. AD - AP-HP, Service de Pneumologie, Centre de Reference de l'Hypertension Pulmonaire, Hopital Bicetre, Le Kremlin-Bicetre, France. AD - INSERM UMR_S 999, Hopital Marie Lannelongue, Le Plessis Robinson, France. FAU - Weatherald, Jason AU - Weatherald J AD - Univ Paris-Sud, Faculte de Medecine, Universite Paris-Saclay, Le Kremlin-Bicetre, France. AD - AP-HP, Service de Pneumologie, Centre de Reference de l'Hypertension Pulmonaire, Hopital Bicetre, Le Kremlin-Bicetre, France. AD - INSERM UMR_S 999, Hopital Marie Lannelongue, Le Plessis Robinson, France. AD - Department of Medicine, Division of Respirology, University of Calgary, Calgary, Alberta, Canada. FAU - Sitbon, Olivier AU - Sitbon O AD - Univ Paris-Sud, Faculte de Medecine, Universite Paris-Saclay, Le Kremlin-Bicetre, France. AD - AP-HP, Service de Pneumologie, Centre de Reference de l'Hypertension Pulmonaire, Hopital Bicetre, Le Kremlin-Bicetre, France. AD - INSERM UMR_S 999, Hopital Marie Lannelongue, Le Plessis Robinson, France. FAU - Parent, Florence AU - Parent F AD - Univ Paris-Sud, Faculte de Medecine, Universite Paris-Saclay, Le Kremlin-Bicetre, France. AD - AP-HP, Service de Pneumologie, Centre de Reference de l'Hypertension Pulmonaire, Hopital Bicetre, Le Kremlin-Bicetre, France. AD - INSERM UMR_S 999, Hopital Marie Lannelongue, Le Plessis Robinson, France. FAU - Fabre, Dominique AU - Fabre D AD - Univ Paris-Sud, Faculte de Medecine, Universite Paris-Saclay, Le Kremlin-Bicetre, France. AD - INSERM UMR_S 999, Hopital Marie Lannelongue, Le Plessis Robinson, France. AD - Service de Chirurgie Thoracique et Vasculaire et de Transplantation Cardiopulmonaire, Hopital Marie Lannelongue, Le Plessis Robinson, France. FAU - Mussot, Sacha AU - Mussot S AD - Univ Paris-Sud, Faculte de Medecine, Universite Paris-Saclay, Le Kremlin-Bicetre, France. AD - INSERM UMR_S 999, Hopital Marie Lannelongue, Le Plessis Robinson, France. AD - Service de Chirurgie Thoracique et Vasculaire et de Transplantation Cardiopulmonaire, Hopital Marie Lannelongue, Le Plessis Robinson, France. FAU - Dartevelle, Philippe AU - Dartevelle P AD - Univ Paris-Sud, Faculte de Medecine, Universite Paris-Saclay, Le Kremlin-Bicetre, France. AD - INSERM UMR_S 999, Hopital Marie Lannelongue, Le Plessis Robinson, France. AD - Service de Chirurgie Thoracique et Vasculaire et de Transplantation Cardiopulmonaire, Hopital Marie Lannelongue, Le Plessis Robinson, France. FAU - Humbert, Marc AU - Humbert M AD - Univ Paris-Sud, Faculte de Medecine, Universite Paris-Saclay, Le Kremlin-Bicetre, France. AD - AP-HP, Service de Pneumologie, Centre de Reference de l'Hypertension Pulmonaire, Hopital Bicetre, Le Kremlin-Bicetre, France. AD - INSERM UMR_S 999, Hopital Marie Lannelongue, Le Plessis Robinson, France. FAU - Simonneau, Gerald AU - Simonneau G AD - Univ Paris-Sud, Faculte de Medecine, Universite Paris-Saclay, Le Kremlin-Bicetre, France. AD - AP-HP, Service de Pneumologie, Centre de Reference de l'Hypertension Pulmonaire, Hopital Bicetre, Le Kremlin-Bicetre, France. AD - INSERM UMR_S 999, Hopital Marie Lannelongue, Le Plessis Robinson, France. FAU - Fadel, Elie AU - Fadel E AD - Univ Paris-Sud, Faculte de Medecine, Universite Paris-Saclay, Le Kremlin-Bicetre, France. AD - INSERM UMR_S 999, Hopital Marie Lannelongue, Le Plessis Robinson, France. AD - Service de Chirurgie Thoracique et Vasculaire et de Transplantation Cardiopulmonaire, Hopital Marie Lannelongue, Le Plessis Robinson, France. LA - eng PT - Journal Article DEP - 20180621 PL - United States TA - PLoS One JT - PloS one JID - 101285081 SB - IM MH - Age Factors MH - Aged MH - Chronic Disease MH - *Endarterectomy MH - Female MH - Humans MH - *Hypertension, Pulmonary/metabolism/pathology/surgery MH - Male MH - Middle Aged MH - Predictive Value of Tests MH - *Pulmonary Embolism/metabolism/mortality/surgery MH - *Registries MH - Retrospective Studies MH - Risk Factors MH - Time Factors PMC - PMC6013172 COIS- The authors have declared that no competing interests exist. EDAT- 2018/06/22 06:00 MHDA- 2018/12/12 06:00 PMCR- 2018/06/21 CRDT- 2018/06/22 06:00 PHST- 2018/02/21 00:00 [received] PHST- 2018/05/15 00:00 [accepted] PHST- 2018/06/22 06:00 [entrez] PHST- 2018/06/22 06:00 [pubmed] PHST- 2018/12/12 06:00 [medline] PHST- 2018/06/21 00:00 [pmc-release] AID - PONE-D-18-05734 [pii] AID - 10.1371/journal.pone.0198198 [doi] PST - epublish SO - PLoS One. 2018 Jun 21;13(6):e0198198. doi: 10.1371/journal.pone.0198198. eCollection 2018.