Early experience with pulmonary endarterectomy in Bulgaria-case series.
| Autor: | Ignatov G; Department of Surgery, Lozenetz University Hospital, Sofia, Bulgaria., Ng CY; Department of Surgery, Royal Papworth Hospital, Cambridge, UK., Tan Z; Division of Anaesthesiology and Perioperative Medicine, Department of Anaesthesiology, Singapore General Hospital, Singapore, Singapore., Velchev V; Department of Cardiology, University Multiprofile Hospital St. Anna, Sofia, Bulgaria., Kurkchieva T; Department of Perfusion, Acibadem City Clinic, Cardiovascular Centre, Sofia, Bulgaria., Whitbread JC; Cambridge Perfusion Services, Royal Papworth Hospital, Cambridge, UK., Valchanov KP; Division of Anaesthesiology and Perioperative Medicine, Department of Anaesthesiology, Singapore General Hospital, Singapore, Singapore. |
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| Jazyk: | angličtina |
| Zdroj: | Annals of translational medicine [Ann Transl Med] 2023 Mar 15; Vol. 11 (5), pp. 216. Date of Electronic Publication: 2023 Mar 07. |
| DOI: | 10.21037/atm-22-4370 |
| Abstrakt: | Background: Pulmonary arterial hypertension (PAH) is a condition that limits the quality of life and life expectancy. The predicted mortality at 1 year is estimated at 30-40% without treatment. Of the types of PAH, chronic thromboembolic pulmonary hypertension (CTEPH) is most amenable to treatment and guidelines recommend pulmonary endarterectomy (PEA) surgery for 'operable' patients (where disease is found in the proximal pulmonary vessels). Traditionally these patients were referred to a European centre with the complexities of international travel, pre- and post-operative care, and funding. We sought to establish a national PEA programme to serve the Bulgarian population and avoid some of the problems of international healthcare. Case Description: A total of 11 patients underwent PEA in 2 cardiac centres in Bulgaria (Acibadem Hospital and Government Hospital Lozenetz Sofia). The age of patients ranged from 22 to 80. The preoperative pulmonary vascular resistance (PVR) ranged from 309 to 1,906 dynes/sec/cm -5 . For the surviving patients the average PVR reduction was 615 dynes/sec/cm -5 at 6 months, the average intensive care unit (ICU) stay 6.7 days, and hospitalisation 15.2 days. Nine out of 11 patients survived to hospital discharge and 6 months follow, all with normalised PVR and exercise tolerance. Conclusions: We present our results of initial experience with PEA in Bulgaria with encouraging results. Our work shows that inter-European relationship for healthcare can be productive and offer safe treatment on local level. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://atm.amegroups.com/article/view/10.21037/atm-22-4370/coif). The authors have no conflicts of interest to declare. (2023 Annals of Translational Medicine. All rights reserved.) |
| Databáze: | MEDLINE |
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