Original articleGeneral thoracicSymptoms Are More Useful Than Echocardiography in Patient Selection for Pulmonary Endarterectomy
Section snippets
Material and Methods
After approval by the University Health Network Institutional Research Ethics Board, we retrospectively reviewed all patients referred to the Toronto CTEPH Program between January 2005 and June 2015. Patients with normal VQ scans were excluded. Patients with mismatched perfusion defects on VQ scans were then divided into three groups according to TTE and right heart catheterization (RHC) performed at the time of their assessment: (1) typical CTEPH group (PH likely on TTE confirmed by RHC), (2)
Results
From January 2005 until June 2015, 252 patients were reviewed in the CTEPH clinic at our center. Ten patients were found to have a normal VQ scan, and 17 patients did not have a RHC and were therefore excluded from this analysis. Of 225 patients with a persistently abnormal VQ scan despite 3 months of anticoagulation, 188 (84%) were likely to have PH on TTE, 21 (9%) possibly had PH, and 16 (7%) were unlikely to have PH on TTE at the time of their assessment. Echocardiographic findings
Comment
CTEPH is increasingly recognized as one of the main causes of right heart failure. PEA has been shown to be a durable treatment for this disease, improving both symptoms and prognosis [1]. CTEPH as a disease encompasses patients with a wide range of disease severity. By definition, PH is present when the mean PAP is ≥25 mm Hg [6]. Therefore, CTEPH patients range from those with mild PH to severe PH with right heart failure and multisystem organ dysfunction. As CT technology improves, rates of
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