Surgical Treatment of Another Sequelae of Covid-19: Post-Covid Chronic Thromboembolic Pulmonary Hypertension

PS069 

Abstract Submission 

Nezih Ermerak (1), Sehnaz Yildizeli (2), Derya Kocakaya (2), Gamze Gul Tiryaki (3), Yasin Guctekin (4), Bulent Multu (5), Koray Ak (4), Serpil Tas (6), Bedrettin YILDIZELI (1)

(1) Marmara University Hospital, Department of Thoracic Surgery, Istanbul, N/A, (2) Marmara University, Department of Pulmonology, Istanbul, NA, (3) Marmara University, Department of Thoracic Surgery, Istanbul, N/A, (4) Marmara University, Department of Cardiovascular Surgery, Istanbul, NA, (5) Marmara University, Department of Cardiology, Istanbul, NA, (6) Kartal Kosuyolu Hospital, Department of Cardiovascular Surgery, Istanbul, NA

Nezih Ermerak    -  Contact Me
Marmara University Hospital, Department of Thoracic Surgery

Sehnaz Yildizeli    -  Contact Me
Marmara University, Department of Pulmonology

Derya Kocakaya    -  Contact Me
Marmara University, Department of Pulmonology

Gamze Gul Tiryaki    -  Contact Me
Marmara University, Department of Thoracic Surgery

Yasin Guctekin    -  Contact Me
Marmara University, Department of Cardiovascular Surgery

Bulent Multu    -  Contact Me
Marmara University, Department of Cardiology

Koray Ak    -  Contact Me
Marmara University, Department of Cardiovascular Surgery

Serpil Tas    -  Contact Me
Kartal Kosuyolu Hospital, Department of Cardiovascular Surgery

bedrettin yildizeli    -  Contact Me
Marmara University Hospital, Department of Thoracic Surgery

Nezih Ermerak    -  Contact Me
Marmara University Hospital

Objective: Covid-19 is still an ongoing entity and every day we face new sequelae of the disease. It's association with thrombosis is a well-known fact. We hereby present surgical results of patients who are treated with post-Covid CTEPH.
Methods: Data were collected prospectively among patients who underwent pulmonary endarterectomy (PEA) and had a diagnosis of Post-Covid CTEPH. Between July 2021 and July 2022, 108 consecutive patients underwent PEA at our institution. Patients who had pulmonary emboli during or after infection with Covid-19 were followed up at least 6 months with anticoagulants and the ones who developed CTEPH were treated with pulmonary endarterectomy. All data were retrospectively reviewed from database in terms of demographics, clinical features, complications, short and long-term results, length of hospital stay, morbidity and mortality. The ethical application for this study was approved by the ethics committee of our center.
Results: Eleven patients (seven male, four female, median age 52 (22–63) years) were identified. Patients who had a past medical history of pulmonary emboli, any kind of coagulopathy or major risk factors were excluded from the study. Mortality was observed in one patient due to sepsis on the 5th postoperative day. One patient needed two-vessel CABG in addition to PEA. Pulmonary vascular resistance improved significantly from 572 dyn/s/cm-5 (240–1192) to 240 (195–377) dyn/s/cm-5 (p<0.005). Significant difference was also detected in median mPAP as decline from 40 mmHg (24-54) to 24 mmHg (15-36) (p<0.005). following surgery. Median time from Covid-19 disease to surgery was 12 months (6 -24). Median length of hospital stay of the survivors was 10 days (8-14). Median follow-up after PEA was 8 (2-14) months for all the survivors.
Conclusions: Patients who had Covid-19 may develop pulmonary emboli and CTEPH. Pulmonary endarterectomy is the only therapeutic option for the treatment of those patients as in the other CTEPH patients. We hereby report the first series of post-Covid CTEPH patients who were surgically treated. As we see a lot of symptoms and clinical manifestations in patients who had Covid-19, we should always remember CTEPH in the differential diagnosis.

End Stage Lung Disease and Lung Transplantation