Patients with Persistent/Recurrent CTEPH After PTE
Even after PTE, CTEPH may persist.
These patients would be categorized as WHO Group 4 patients.3
- Multiple reviews of the literature—including a systematic review of studies published from 1999 to 2010 that followed a total of 2,729 patients—show that residual PH following pulmonary endarterectomy has been reported at rates of between 10% to 35%.25-28
- In a study that followed 469 patients diagnosed with CTEPH at any one of 5 PH centers in the UK, 198 patients underwent PTE,* and 162 survived the surgery to discharge.29
- These 162 patients had a repeat RHC at 3 months: 70 (35%) had mPAP ≥25 mmHg and PVR ≥240 dyn∙s∙cm-5, indicating persistent PH.29
- Compared with the 65% of patients (n=92) who did not have persistent PH following PTE surgery, those with persistent PH had significantly worse presurgical hemodynamics—mPAP 50.5 vs 46.5 mmHg; PVR 1144 vs 934 dyn∙s∙cm-5.29
- However, there appeared to be little difference in survival rates between patients with persistent PH and those without persistent PH at 1 and 3 years.29
- A similar finding was reported from a study of 314 patients from a single UK center: Persistent PH after PTE appeared to have no significant effect on survival.25
- But patients with no persistent PH had fewer symptoms after surgery and better 6MWD than patients with persistent PH.25
- All patients diagnosed with CTEPH should receive lifelong anticoagulation.3
*Also called pulmonary endarterectomy or PEA.
View additional information about patients with inoperable or recurrent CTEPH.
Residual PH following pulmonary endarterectomy has been reported at rates of between 10% to 35%.25-28