Pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension. Ten years experience in Denmark

Scand Cardiovasc J. 2006 Feb;40(1):49-53. doi: 10.1080/14017430500338513.


Objectives: To evaluate survival and functional outcome in patients treated by pulmonary endarterectomy (PEA) for chronic thromboembolic pulmonary hypertension in Denmark.

Design: Follow-up of the first 50 patients operated at Aarhus University Hospital, Denmark.

Results: Fifty patients underwent PEA in the period from 1994 to mid 2004. Prior to surgery all patients were in World Health Organization (WHO) function class III (n=33) or IV (n=17). The mean pulmonary artery pressure was 50 mmHg (range 25-76), cardiac index 1.8 l min(-1)m(-2) (range 0.8-2.8) and pulmonary vascular resistance 819 dyn s cm(-5) (range 241-3,067). In-hospital mortality was 12/50 (24%). Surgical mortality was highest in the early period. Since year 2000 in-hospital deaths occurred in only 2 among 23 patients (9%). Leading causes of death were persistent pulmonary hypertension and bleeding. Three patients died during long-term follow-up with a median observation time of 3 years. The overall 5 year survival rate was 74%. At 3 months follow-up 90% of the patients (34/38) had improved one or more WHO functional classes and the systolic pulmonary artery pressure estimated by Doppler echocardiography had decreased from 80 mmHg (range 49-115) to 43 mmHg (range 14-95).

Conclusion: Pulmonary endarterectomy has been successfully implemented in Denmark. The perioperative mortality was reduced over time to 9% during the past 5 years. Functional outcome and long-term survival were excellent stressing the importance of surgical treatment for chronic thromboembolic pulmonary hypertension.

MeSH terms

  • Adult
  • Aged
  • Denmark
  • Endarterectomy* / mortality
  • Endarterectomy* / standards
  • Female
  • Follow-Up Studies
  • Humans
  • Hypertension, Pulmonary / etiology
  • Hypertension, Pulmonary / mortality
  • Hypertension, Pulmonary / surgery*
  • Male
  • Middle Aged
  • Postoperative Complications* / mortality
  • Pulmonary Artery / surgery
  • Pulmonary Embolism / complications
  • Pulmonary Embolism / mortality
  • Pulmonary Embolism / surgery*
  • Referral and Consultation
  • Survival Analysis