Clinical and functional status and postoperative complications in patients with chronic thromboembolic pulmonary hypertension in the age aspect
https://doi.org/10.38109/2075-082X-2023-4-31-37
Abstract
Aim. To study the clinical and functional status and the early postoperative follow-up in elderly patients with chronic thromboembolic pulmonary hypertension (CTEPH).
Material and methods. Patients with CTEPH were divided into two groups: group 1 (35 people) – patients ≥65 years old, group 2 (98 people) – <65 years old. The baseline clinical and functional data of both groups and the in-hospital period after pulmonary endarterectomy, were analysed.
Results. Patients with CTEPH ≥65 years old compared with patients <65 years old were characterized by a higher comorbidity, a higher incidence of adverse cardiovascular events and the presence of chronic heart failure IV class (p<0.05). Echo-CG data in patients with CTEPH ≥65 years old were characterized by a large size of the left atrium, more pronounced hypertrophy of the right ventricle free wall, interventricular septum and the left ventricular posterior wall compared with younger patients (p<0.05). Also, in patients ≥65 years old, lower values of the left ventricular ejection fraction were found with preservation of global myocardial contractility (p<0.05). The early postoperative period in patients with CTEPH ≥65 years is characterized by a more severe course compared to the group of patients <65 years due to a larger proportion of patients with the development of newly diagnosed atrial fibrillation, multiple organ failure and postoperative bleeding (p<0.05). Despite this, there were no intergroup differences in the length of the hospital period and in-hospital mortality (p>0.05).
Conclusion. The early postoperative results of pulmonary endarterectomy in elderly patients with CTEPH showed no differences in the length of hospital stay and in-hospital mortality compared with younger patients, which indicates the feasibility of surgical treatment of this category of patients in the specialized cardiac surgical centers.
About the Authors
O. V. KamenskayaRussian Federation
Oksana V. Kamenskaya - Dr. of Sci. (Med.), Head of the Laboratory of Clinical Physiology, the Research Department of anesthesiology and critical care medicine.
15 Rechkunovskaya street, Novosibirsk 630055
A. S. Klinkova
Russian Federation
Asya S. Klinkova - Cand. of Sci. (Med.), researcher, the Laboratory of Clinical Physiology, the Research Department of anesthesiology and critical care medicine.
15 Rechkunovskaya street, Novosibirsk 630055
I. Y. Loginova
Russian Federation
Irina Y. Loginova - Cand. of Sci. (Biol.), researcher, the Laboratory of Clinical Physiology, the Research Department of anesthesiology and critical care medicine.
15 Rechkunovskaya street, Novosibirsk 630055
S. S. Porotnikova
Russian Federation
Svetlana S. Porotnikova - researcher, the Laboratory of Clinical Physiology, the Research Department of anesthesiology and critical care medicine.
15 Rechkunovskaya street, Novosibirsk 630055
I. I. Volkova
Russian Federation
Irina I. Volkova - Dr. of Sci. (Med.), doctor of functional diagnostics, Head of the Department of Ultrasound and Functional Diagnostics.
15 Rechkunovskaya street, Novosibirsk 630055
D. V. Doronin
Russian Federation
Dmitrij V. Doronin - Dr. of Sci. (Med.), Cardiologist, Cardiac Surgery Department of Aorta and Coronary Arteries.
15 Rechkunovskaya street, Novosibirsk 630055
V. N. Lomivorotov
Russian Federation
Vladimir N. Lomivorotov - Dr. of Sci. (Med.), Professor, the training department.
15 Rechkunovskaya street, Novosibirsk 630055
A. M. Chernyavskiy
Russian Federation
Aleksandr M. Chernyavskiy - Dr. of Sci. (Med.), Corresponding Member of RAS, Professor, general director.
15 Rechkunovskaya street, Novosibirsk 630055
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Review
For citations:
Kamenskaya O.V., Klinkova A.S., Loginova I.Y., Porotnikova S.S., Volkova I.I., Doronin D.V., Lomivorotov V.N., Chernyavskiy A.M. Clinical and functional status and postoperative complications in patients with chronic thromboembolic pulmonary hypertension in the age aspect. Systemic Hypertension. 2023;20(4):31-37. (In Russ.) https://doi.org/10.38109/2075-082X-2023-4-31-37