Histopathological examination by lung biopsy for the evaluation of operability and postoperative prognosis in patients with chronic thromboembolic pulmonary hypertension

Shigeo Yamaki, Motomi Ando, Yoshihiro Fukumoto, Yoshiro Higuchi, Kan Kaneko, Kay Maeda, Hiroaki Shimokawa

Research output: Contribution to journalArticlepeer-review

22 Citations (Scopus)

Abstract

Background: To evaluate the prognosis after pulmonary thromboendarterectomy (PTE) in patients with chronic thromboembolic pulmonary hypertension (CTEPH), a lung biopsy was performed in 34 patients with central CTEPH and in 7 patients with peripheral CTEPH during PTE. Methods and Results: Postoperative prognosis was classified from A to E based on the postoperative hemodynamic parameters and clinical condition, and was compared with the index of occlusion (IOCTEPH), which indicates the degree of occlusion in the small pulmonary arteries. Criteria of (A-E) were established only for central CTEPH. Category (A) corresponded to an IOCTEPH from 1.0 to 1.4, (B) from 1.5 to 1.7, (C) from 1.8 to 2.0, and (D) from 2.1 to 2.4. One patient with an index of 3.0 was rated as (E). This patient had collateral vessels around the obstructed small pulmonary arteries and died postoperatively. In all 12 patients who underwent PTE after the criteria were established, postoperative hemodynamic parameters and clinical conditions were consistent with the IOCTEPH. One patient with a high degree of medial atrophy in their small pulmonary arteries died after PTE. Conclusions: These results indicate that a lung biopsy during PTE is useful for prognostication in patients with CTEPH.

Original languageEnglish
Pages (from-to)476-482
Number of pages7
JournalCirculation Journal
Volume78
Issue number2
DOIs
Publication statusPublished - 2014
Externally publishedYes

Keywords

  • Lung biopsy
  • Operative indication
  • Prognosis
  • Pulmonary vascular disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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