Age should not be a barrier for pulmonary endarterectomy in carefully selected patients

Michael Newnham; Jules Hernandez-Sanchez; John Dunning; Choo Ng; Steven Tsui; Katherine Bunclark; Karen Sheares; Dolores Taboada; Mark Toshner; Joanna Pepke-Zaba; David Jenkins; John Cannon

doi:10.1183/13993003.01804-2017

Age should not be a barrier for pulmonary endarterectomy in carefully selected patients

Michael Newnham, Jules Hernandez-Sanchez, John Dunning, Choo Ng, Steven Tsui, Katherine Bunclark, Karen Sheares, Dolores Taboada, Mark Toshner, Joanna Pepke-Zaba, David Jenkins, John Cannon

Applied Health Research

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Abstract

Pulmonary endarterectomy (PEA) is the treatment of choice in operable chronic thromboembolic pulmonary hypertension (CTEPH) with excellent long-term outcomes [1]. It is a complex surgical procedure requiring cardiopulmonary bypass and removal of obstructive thromboembolic material during periods of deep hypothermic circulatory arrest [1]. We have observed an increase in the number of older CTEPH patients referred for consideration of PEA, which is consistent with other cardiothoracic surgeries. The UK population is ageing with a projected 3% increase in subjects aged >85 years in the next 20 years [2]. This may be mirrored by patients with CTEPH getting older, as the incidence of pulmonary embolism, which frequently precedes CTEPH, markedly increases with age [3, 4]. Furthermore, an epidemiological analysis by Gall et al. [5] has projected that the annual incidence of CTEPH will increase over the next 10 years. Therefore, the management of CTEPH in older patients is a pertinent topic for investigation.

Original language	English
Article number	1701804
Number of pages	4
Journal	European Respiratory Journal
Volume	50
Issue number	6
DOIs	https://doi.org/10.1183/13993003.01804-2017
Publication status	Published - 7 Dec 2017

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title = "Age should not be a barrier for pulmonary endarterectomy in carefully selected patients",

abstract = "Pulmonary endarterectomy (PEA) is the treatment of choice in operable chronic thromboembolic pulmonary hypertension (CTEPH) with excellent long-term outcomes [1]. It is a complex surgical procedure requiring cardiopulmonary bypass and removal of obstructive thromboembolic material during periods of deep hypothermic circulatory arrest [1]. We have observed an increase in the number of older CTEPH patients referred for consideration of PEA, which is consistent with other cardiothoracic surgeries. The UK population is ageing with a projected 3% increase in subjects aged >85 years in the next 20 years [2]. This may be mirrored by patients with CTEPH getting older, as the incidence of pulmonary embolism, which frequently precedes CTEPH, markedly increases with age [3, 4]. Furthermore, an epidemiological analysis by Gall et al. [5] has projected that the annual incidence of CTEPH will increase over the next 10 years. Therefore, the management of CTEPH in older patients is a pertinent topic for investigation.",

author = "Michael Newnham and Jules Hernandez-Sanchez and John Dunning and Choo Ng and Steven Tsui and Katherine Bunclark and Karen Sheares and Dolores Taboada and Mark Toshner and Joanna Pepke-Zaba and David Jenkins and John Cannon",

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doi = "10.1183/13993003.01804-2017",

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T1 - Age should not be a barrier for pulmonary endarterectomy in carefully selected patients

AU - Newnham, Michael

AU - Hernandez-Sanchez, Jules

AU - Dunning, John

AU - Ng, Choo

AU - Tsui, Steven

AU - Bunclark, Katherine

AU - Sheares, Karen

AU - Taboada, Dolores

AU - Toshner, Mark

AU - Pepke-Zaba, Joanna

AU - Jenkins, David

AU - Cannon, John

PY - 2017/12/7

Y1 - 2017/12/7

N2 - Pulmonary endarterectomy (PEA) is the treatment of choice in operable chronic thromboembolic pulmonary hypertension (CTEPH) with excellent long-term outcomes [1]. It is a complex surgical procedure requiring cardiopulmonary bypass and removal of obstructive thromboembolic material during periods of deep hypothermic circulatory arrest [1]. We have observed an increase in the number of older CTEPH patients referred for consideration of PEA, which is consistent with other cardiothoracic surgeries. The UK population is ageing with a projected 3% increase in subjects aged >85 years in the next 20 years [2]. This may be mirrored by patients with CTEPH getting older, as the incidence of pulmonary embolism, which frequently precedes CTEPH, markedly increases with age [3, 4]. Furthermore, an epidemiological analysis by Gall et al. [5] has projected that the annual incidence of CTEPH will increase over the next 10 years. Therefore, the management of CTEPH in older patients is a pertinent topic for investigation.

AB - Pulmonary endarterectomy (PEA) is the treatment of choice in operable chronic thromboembolic pulmonary hypertension (CTEPH) with excellent long-term outcomes [1]. It is a complex surgical procedure requiring cardiopulmonary bypass and removal of obstructive thromboembolic material during periods of deep hypothermic circulatory arrest [1]. We have observed an increase in the number of older CTEPH patients referred for consideration of PEA, which is consistent with other cardiothoracic surgeries. The UK population is ageing with a projected 3% increase in subjects aged >85 years in the next 20 years [2]. This may be mirrored by patients with CTEPH getting older, as the incidence of pulmonary embolism, which frequently precedes CTEPH, markedly increases with age [3, 4]. Furthermore, an epidemiological analysis by Gall et al. [5] has projected that the annual incidence of CTEPH will increase over the next 10 years. Therefore, the management of CTEPH in older patients is a pertinent topic for investigation.

U2 - 10.1183/13993003.01804-2017

DO - 10.1183/13993003.01804-2017

M3 - Letter

SN - 0903-1936

VL - 50

JO - European Respiratory Journal

JF - European Respiratory Journal

IS - 6

M1 - 1701804

ER -

Age should not be a barrier for pulmonary endarterectomy in carefully selected patients

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