Background: This study aims to reduce the uncertainity related to the prognosis after surgery of the acute pulmonary embolism (APE) and chronic thromboembolic pulmonary hypertension (CTPHT) patients, and to encourage physicians to consider surgical treatment options based on the evidence-based data which suggests that surgery offers the best chance for improvement in these patients.

Methods: Between February 2009 and October 2010, seven cases (3 males, 4 females; mean age 43.8±18.5 years; range 25 to 73 years) who were operated on due to APE and CTPHT were included in this observational and retrospective study. The preand postoperative mean pulmonary artery pressure (mPAP), New York Heart Association (NYHA) functional class, and length of stay in the intensive care unit (ICU) and hospital along with the demographic, clinical and operational characteristics of the patients were recorded. Statistical analyses were performed using nonparametric tests due to the limited number of cases. Wilcoxon’s test was used to compare the groups.

Results: The mPAP reduced by 20 mmHg (range 5-53) following surgery, and the mPAPs in all the patients, except for the sixth case, decreased below 30 mmHg. The pre- and postoperative mPAPs were 43 mmHg (range 33-68) and 23 mmHg (range 15-37), respectively. This indicated that a significant reduction occurred following surgery (z=-2.36; p=0.018). In addition, the NYHA functional class of the patients improved by one unit following surgery (range I-III). The patients pre- and postoperative NYHA classes were III (II-III) and II (I-II), respectively. The improvement after surgery was significant with a decline in the NYHA class (z=-2.26; p=0.024). The patients also averaged a stay of three days in the ICU (range 2-14) and 9.5 days (range 5-27) in the hospital.

Conclusion: Our study results suggest that physicians should not be reluctant to choose the surgical option and should endeavor to improve the quality of life of their patients through a detailed preoperative assessment and proper patient selection.

Keywords : Acute pulmonary embolism; chronic thromboembolic pulmonary hypertension; functional capacity; mean pulmonary artery pressure; pulmonary thromboendarterectomy