Affiliation:
1. E.N. Meshalkin National Medical Research Center of the Ministry of Health of the Russian Federation
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.