P157. Worldwide Pulmonary Endarterectomy Activity and Outcomes from the Second International Chronic Thromboembolic Pulmonary Hypertension Registry
Presented During: Adult Cardiac Poster Session II
Royal Papworth Hospital
Cambridge, UK
United Kingdom - Contact Me
David Jenkins is a consultant cardiothoracic surgeon at the Royal Papworth Hospital, Cambridge, UK.
Monday, May 4, 2026: 9:00 AM - 4:00 PM
McCormick Place Lakeside Center
Room: Exhibit Hall, Poster Area
Description
Objective: Chronic thromboembolic pulmonary hypertension (CTEPH) results from incomplete resolution of acute pulmonary embolism. Three treatment modalities are now available, Pulmonary Endarterectomy (PTE/PEA) surgery, with Balloon Pulmonary Angioplasty (BPA) and approved drug therapy for inoperable patients. The second international CTEPH registry aimed to investigate CTEPH management internationally and represents the largest PTE registry experience. PTE results were assessed and compared with the first European registry, reported in 2011, before the era when BPA and licenced drug therapy were available.
Methods: Consecutive incident patients with CTEPH were recruited into the registry between February 2015 and September 2016, with follow up to September 2019 from 34 participating international centres in 20 countries.
Results: One thousand and nine patients were recruited and 605 (60%) underwent PTE surgery at 29 centres, compared with 57% in the first registry, with a higher utilisation in Europe and the USA compared with other areas. BPA was utilised in 185 (18%) patients and 219 (22%) patients underwent no mechanical therapy. The median age of surgical patients was 60 [49,70] years and 53% were male; the time between symptoms and diagnosis was 15 months, all unchanged from the first registry. The majority of patients (75%) were in functional classes III/IV, with a mean pulmonary artery pressure of 45 [36,51] mmHg and pulmonary vascular resistance (PVR) 646 [456,906] dyn.s.cm-5. PVR was reduced to 254 dyn.s.cm-5 (by 60%) following surgery. Mortality at 30 days was 2.4%, (0.8% for patients with PVR < 800 dyn.s.cm-5), which was less than the first registry (5.2 %). Survival at 1 year was 95%, compared with 92% in the first registry. The 4 centres performing > 50 operations per year had the lowest 30-day mortality (2%), least ECMO use (3%), and highest 1 year survival 97%. Survival to 5 years, compared with the other modalities of treatment, is shown in figure 1.
Conclusions: In the second international CTEPH registry, despite the availability of two new treatments, PTE remains the most common treatment for CTEPH with improved outcomes, low operative mortality and excellent medium-term survival.
Authors
David Jenkins (1), Elie Fadel (2), Christoph B. Wiedenroth (3), Eckhard Mayer (3), Andrea D''Armini (4), bedrettin yildizeli (5), Marion Delcroix (6), Nick H. Kim (7), Hiromi Matsubara (8), Irene Lang (9), Joanna Pepke-Zaba (1), Gerald Simonneau (10), Aruna Bansal (11), Michael Madani (12)
Institutions
(1) Royal Papworth Hospital, Cambridge, UK, (2) Marie Lannelongue Hospital, Paris, France, (3) Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany, (4) University of Pavia, Pavia, Italy, (5) Marmara University,, Istanbul, Turkey, (6) University Hospitals Leuven, Leuven, Belgium, (7) UC San Diego Health, La Jolia, CA, (8) Okayama Medical center, Okayama, Japan, (9) Medical University of Vienna, Vienna, Austria, (10) Universite Paris-Sud, Paris, France, (11) Acclarogen Ltd, Cambridge, UK, (12) UC San Diego Health, La Jolla, CA
Methods: Consecutive incident patients with CTEPH were recruited into the registry between February 2015 and September 2016, with follow up to September 2019 from 34 participating international centres in 20 countries.
Results: One thousand and nine patients were recruited and 605 (60%) underwent PTE surgery at 29 centres, compared with 57% in the first registry, with a higher utilisation in Europe and the USA compared with other areas. BPA was utilised in 185 (18%) patients and 219 (22%) patients underwent no mechanical therapy. The median age of surgical patients was 60 [49,70] years and 53% were male; the time between symptoms and diagnosis was 15 months, all unchanged from the first registry. The majority of patients (75%) were in functional classes III/IV, with a mean pulmonary artery pressure of 45 [36,51] mmHg and pulmonary vascular resistance (PVR) 646 [456,906] dyn.s.cm-5. PVR was reduced to 254 dyn.s.cm-5 (by 60%) following surgery. Mortality at 30 days was 2.4%, (0.8% for patients with PVR < 800 dyn.s.cm-5), which was less than the first registry (5.2 %). Survival at 1 year was 95%, compared with 92% in the first registry. The 4 centres performing > 50 operations per year had the lowest 30-day mortality (2%), least ECMO use (3%), and highest 1 year survival 97%. Survival to 5 years, compared with the other modalities of treatment, is shown in figure 1.
Conclusions: In the second international CTEPH registry, despite the availability of two new treatments, PTE remains the most common treatment for CTEPH with improved outcomes, low operative mortality and excellent medium-term survival.
Authors
David Jenkins (1), Elie Fadel (2), Christoph B. Wiedenroth (3), Eckhard Mayer (3), Andrea D''Armini (4), bedrettin yildizeli (5), Marion Delcroix (6), Nick H. Kim (7), Hiromi Matsubara (8), Irene Lang (9), Joanna Pepke-Zaba (1), Gerald Simonneau (10), Aruna Bansal (11), Michael Madani (12)
Institutions
(1) Royal Papworth Hospital, Cambridge, UK, (2) Marie Lannelongue Hospital, Paris, France, (3) Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany, (4) University of Pavia, Pavia, Italy, (5) Marmara University,, Istanbul, Turkey, (6) University Hospitals Leuven, Leuven, Belgium, (7) UC San Diego Health, La Jolia, CA, (8) Okayama Medical center, Okayama, Japan, (9) Medical University of Vienna, Vienna, Austria, (10) Universite Paris-Sud, Paris, France, (11) Acclarogen Ltd, Cambridge, UK, (12) UC San Diego Health, La Jolla, CA
Presentation Duration
There is no formal presentation for posters. Your poster will be on display on your assigned day from 9:00AM - 4:00PM
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ADULT CARDIAC
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