PMID- 31474014
OWN - NLM
STAT- MEDLINE
DCOM- 20190910
LR  - 20190910
IS  - 1565-1088 (Print)
VI  - 21
IP  - 8
DP  - 2019 Aug
TI  - Pulmonary Endarterectomy Surgery for Chronic Thromboembolic Pulmonary 
      Hypertension: A Small-Volume National Referral Center Experience.
PG  - 528-531
AB  - BACKGROUND: Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare, 
      distinct pulmonary vascular disease, which is caused by chronic obstruction of 
      major pulmonary arteries. CTEPH can be cured by pulmonary endarterectomy (PEA). 
      PEA for CTEPH is a challenging procedure, and patient selection and the 
      perioperative management are complex, requiring significant experience. 
      OBJECTIVES: To describe the establishment of a national CTEPH-PEA center in 
      Israel and present results of surgery. METHODS: In this study, we reviewed the 
      outcomes of PEA in a national referral, multi-disciplinary center for CTEPH-PEA. 
      The center was established by collaborating with a high-volume center in Europe. 
      A multidisciplinary team from our hospital (pulmonary hypertension specialist, 
      cardiac surgeon, cardiac anesthesiologist and cardiac surgery intensivist was 
      trained under the guidance of an experienced team from the European center. 
      RESULTS: A total of 38 PEA procedures were performed between 2008 and 2018. We 
      included 28 cases in this analysis for which long-term follow-up data were 
      available. There were two hospital deaths (7%). At follow-up, median New York 
      Heart Association (NYHA) class improved from III to I (P < 0.0001), median 
      systolic pulmonary pressure decreased from 64 mmHg to 26 mmHg (P < 0.0001), and 
      significant improvements were seen in right ventricular function and exercise 
      capacity. CONCLUSIONS: A national center for performance of a rare and complex 
      surgical procedure can be successfully established by collaboration with a 
      high-volume center and by training a dedicated multidisciplinary team.
FAU - Segel, Michael J
AU  - Segel MJ
AD  - Pulmonary Institute, Sheba Medical Center, Tel Hashomer, Israel.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Kogan, Alexander
AU  - Kogan A
AD  - Department of Cardiac Surgery, Leviev Heart Center, Sheba Medical Center, Tel 
      Hashomer, Israel.
AD  - Department of Anesthesiology, Sheba Medical Center, Tel Hashomer, Israel.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Preissman, Sergey
AU  - Preissman S
AD  - Department of Anesthesiology, Sheba Medical Center, Tel Hashomer, Israel.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Agmon-Levin, Nancy
AU  - Agmon-Levin N
AD  - Department of Clinical Immunology, Angioedema and Allergy Unit, Sheba Medical 
      Center, Tel Hashomer, Israel.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Lubetsky, Aaron
AU  - Lubetsky A
AD  - National Hemophilia Center, Institute of Thrombosis and Hemostasis, Sheba Medical 
      Center, Tel Hashomer, Israel.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Fefer, Paul
AU  - Fefer P
AD  - Department of Cardiac Surgery, Leviev Heart Center, Sheba Medical Center, Tel 
      Hashomer, Israel.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Schaefers, Hans-Joachim
AU  - Schaefers HJ
AD  - Department of Thoracic and Cardiovascular Surgery, Saarland University Medical 
      Center, Homburg Saar, Germany.
FAU - Raanani, Ehud
AU  - Raanani E
AD  - Department of Cardiac Surgery, Leviev Heart Center, Sheba Medical Center, Tel 
      Hashomer, Israel.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
LA  - eng
PT  - Journal Article
PL  - Israel
TA  - Isr Med Assoc J
JT  - The Israel Medical Association journal : IMAJ
JID - 100930740
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Chronic Disease
MH  - Endarterectomy/*methods
MH  - Female
MH  - Humans
MH  - Hypertension, Pulmonary/*etiology/*surgery
MH  - Israel
MH  - Male
MH  - Middle Aged
MH  - Pulmonary Artery/surgery
MH  - Pulmonary Embolism/*complications/*surgery
MH  - Referral and Consultation
MH  - Risk Factors
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2019/09/02 06:00
MHDA- 2019/09/11 06:00
CRDT- 2019/09/02 06:00
PHST- 2019/09/02 06:00 [entrez]
PHST- 2019/09/02 06:00 [pubmed]
PHST- 2019/09/11 06:00 [medline]
PST - ppublish
SO  - Isr Med Assoc J. 2019 Aug;21(8):528-531.