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The impact of pulmonary hypertension on morbidity and mortality following major lung resection.

Publication ,  Journal Article
Wei, B; D'Amico, T; Samad, Z; Hasan, R; Berry, MF
Published in: Eur J Cardiothorac Surg
June 2014

OBJECTIVES: Pulmonary hypertension is considered a poor prognostic factor for or even a contraindication to major lung resection, but evidence for this claim is lacking. This study evaluates the impact of pulmonary hypertension on morbidity and mortality following pulmonary lobectomy. METHODS: Adult patients who underwent a lobectomy for cancer and had a transthoracic echocardiogram (TTE) performed within the year prior to the operation were included. Pulmonary hypertension was defined as an estimated right ventricular systolic pressure (RVSP) of ≥36 mmHg by TTE. The preoperative characteristics, intraoperative data and postoperative outcomes of patients with and those without pulmonary hypertension based on TTE were compared. A model for morbidity including published risk factors as well as pulmonary hypertension was developed by multivariable logistic regression. RESULTS: There were 279 patients without pulmonary hypertension and 19 patients with pulmonary hypertension. Patients with pulmonary hypertension had a lower preoperative forced expiratory volume in 1 s and diffusing capacity of the lung for carbon monoxide than patients without pulmonary hypertension and a higher incidence of tricuspid regurgitation and mitral regurgitation, but the groups were otherwise similar. The mean RVSP in the group of patients with pulmonary hypertension was 47 mmHg. Perioperative mortality (0.0 vs 2.9%; P = 1.0) and postoperative complications (57.9 vs 47.7%; P = 0.48) were not significantly different between patients with and those without pulmonary hypertension. The presence of pulmonary hypertension was not a predictor of adverse outcomes in either univariate or multivariate analysis. CONCLUSIONS: Lobectomy may be performed safely in selected patients with pulmonary hypertension, with complication rates comparable with those experienced by patients without pulmonary hypertension.

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Published In

Eur J Cardiothorac Surg

DOI

EISSN

1873-734X

Publication Date

June 2014

Volume

45

Issue

6

Start / End Page

1028 / 1033

Location

Germany

Related Subject Headings

  • Retrospective Studies
  • Respiratory System
  • Postoperative Complications
  • Pneumonectomy
  • Middle Aged
  • Male
  • Lung Neoplasms
  • Hypertension, Pulmonary
  • Humans
  • Female
 

Citation

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Wei, B., D’Amico, T., Samad, Z., Hasan, R., & Berry, M. F. (2014). The impact of pulmonary hypertension on morbidity and mortality following major lung resection. Eur J Cardiothorac Surg, 45(6), 1028–1033. https://doi.org/10.1093/ejcts/ezt495
Wei, Benjamin, Thomas D’Amico, Zainab Samad, Rasha Hasan, and Mark F. Berry. “The impact of pulmonary hypertension on morbidity and mortality following major lung resection.Eur J Cardiothorac Surg 45, no. 6 (June 2014): 1028–33. https://doi.org/10.1093/ejcts/ezt495.
Wei B, D’Amico T, Samad Z, Hasan R, Berry MF. The impact of pulmonary hypertension on morbidity and mortality following major lung resection. Eur J Cardiothorac Surg. 2014 Jun;45(6):1028–33.
Wei, Benjamin, et al. “The impact of pulmonary hypertension on morbidity and mortality following major lung resection.Eur J Cardiothorac Surg, vol. 45, no. 6, June 2014, pp. 1028–33. Pubmed, doi:10.1093/ejcts/ezt495.
Wei B, D’Amico T, Samad Z, Hasan R, Berry MF. The impact of pulmonary hypertension on morbidity and mortality following major lung resection. Eur J Cardiothorac Surg. 2014 Jun;45(6):1028–1033.
Journal cover image

Published In

Eur J Cardiothorac Surg

DOI

EISSN

1873-734X

Publication Date

June 2014

Volume

45

Issue

6

Start / End Page

1028 / 1033

Location

Germany

Related Subject Headings

  • Retrospective Studies
  • Respiratory System
  • Postoperative Complications
  • Pneumonectomy
  • Middle Aged
  • Male
  • Lung Neoplasms
  • Hypertension, Pulmonary
  • Humans
  • Female