Outcomes of Multidisciplinary Care at a Chronic Thromboembolic Pulmonary Hypertension Center
ABSTRACT Recent international guidelines recommend a multidisciplinary evaluation and care model for patients with chronic thromboembolic pulmonary hypertension (CTEPH), but there is a paucity of supporting data. The aim of this study was to describe the outcomes of a multidisciplinary team approach...
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| Format: | Article |
| Language: | English |
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Wiley
2025-04-01
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| Series: | Pulmonary Circulation |
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| Online Access: | https://doi.org/10.1002/pul2.70085 |
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| author | S. Christopher Malaisrie Stephen Chiu Daniel Schimmel Maanasi Samant Ryan Avery Amir Rahsepar Bradley Allen Yasmin Raza Benjamin Freed Ruben Mylvaganam Michael J. Cuttica |
| author_facet | S. Christopher Malaisrie Stephen Chiu Daniel Schimmel Maanasi Samant Ryan Avery Amir Rahsepar Bradley Allen Yasmin Raza Benjamin Freed Ruben Mylvaganam Michael J. Cuttica |
| author_sort | S. Christopher Malaisrie |
| collection | DOAJ |
| description | ABSTRACT Recent international guidelines recommend a multidisciplinary evaluation and care model for patients with chronic thromboembolic pulmonary hypertension (CTEPH), but there is a paucity of supporting data. The aim of this study was to describe the outcomes of a multidisciplinary team approach to the comprehensive care of CTEPH patients. This single‐center cohort study enrolled 166 consecutive adult patients undergoing CTEPH treatment evaluation from 2016 to 2022 at a tertiary care, academic regional referral and comprehensive CTEPH center with pulmonary thromboendarterectomy (PTE) and balloon pulmonary angioplasty (BPA) capabilities. Patients underwent PTE, BPA, or medical management after consensus evaluation by a multidisciplinary team including pulmonary hypertension physicians, surgeons, interventional cardiologists, and radiologists. 86% (142/166) of patients underwent interventional therapies; 100 (60%) underwent PTE and 42 (25%) BPA. Of the 24 (14%) medically treated patients, 13 patients were offered but deferred intervention; 11 patients had non‐intervenable disease. 30‐day mortality in both PTE and BPA was 0%. 1‐ and 3‐year survival was 99% and 96% for PTE, 100% and 93% for BPA, 79% and 79% for medical management. Patients who underwent PTE had the best hemodynamic response (∆PVR: PTE −278.8 ± 366.9 dyne/sec/cm5; BPA −15.9 ± 171.8 dyne/sec/cm5; medical −60.2 ± 233.1 dyne/sec/cm5; p = 0.001), largest improvement in Borg Dyspnea Scale; [PTE −1.0 (−2.8 to 0.0), BPA + 0.5 (−0.8 to 5.0), medical +1.0 (0.75 to 3.0), p = 0.01], and most improvement in NYHA functional class [% improving at least 1 functional class: PTE 64% (47/73), BPA 18% (5/28), medical 21% (4/19), p = 0.0004]. |
| format | Article |
| id | doaj-art-32044c6f352d418eb09fb36ef00adcf4 |
| institution | Kabale University |
| issn | 2045-8940 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Pulmonary Circulation |
| spelling | doaj-art-32044c6f352d418eb09fb36ef00adcf42025-08-20T03:32:18ZengWileyPulmonary Circulation2045-89402025-04-01152n/an/a10.1002/pul2.70085Outcomes of Multidisciplinary Care at a Chronic Thromboembolic Pulmonary Hypertension CenterS. Christopher Malaisrie0Stephen Chiu1Daniel Schimmel2Maanasi Samant3Ryan Avery4Amir Rahsepar5Bradley Allen6Yasmin Raza7Benjamin Freed8Ruben Mylvaganam9Michael J. Cuttica10Division of Cardiac Surgery, Department of Surgery Northwestern University Feinberg School of Medicine Chicago IllinoisDivision of Cardiac Surgery, Department of Surgery Northwestern University Feinberg School of Medicine Chicago IllinoisDivision of Cardiology, Department of Medicine Northwestern University Feinberg School of Medicine Chicago IllinoisDivision of Pulmonary and Critical Care Medicine, Department of Medicine Northwestern University Feinberg School of Medicine Chicago IllinoisDepartment of Radiology Northwestern University Feinberg School of Medicine Chicago IllinoisDepartment of Radiology Northwestern University Feinberg School of Medicine Chicago IllinoisDepartment of Radiology Northwestern University Feinberg School of Medicine Chicago IllinoisDivision of Cardiology, Department of Medicine Northwestern University Feinberg School of Medicine Chicago IllinoisDivision of Cardiology, Department of Medicine Northwestern University Feinberg School of Medicine Chicago IllinoisDivision of Pulmonary and Critical Care Medicine, Department of Medicine Northwestern University Feinberg School of Medicine Chicago IllinoisDivision of Pulmonary and Critical Care Medicine, Department of Medicine Northwestern University Feinberg School of Medicine Chicago IllinoisABSTRACT Recent international guidelines recommend a multidisciplinary evaluation and care model for patients with chronic thromboembolic pulmonary hypertension (CTEPH), but there is a paucity of supporting data. The aim of this study was to describe the outcomes of a multidisciplinary team approach to the comprehensive care of CTEPH patients. This single‐center cohort study enrolled 166 consecutive adult patients undergoing CTEPH treatment evaluation from 2016 to 2022 at a tertiary care, academic regional referral and comprehensive CTEPH center with pulmonary thromboendarterectomy (PTE) and balloon pulmonary angioplasty (BPA) capabilities. Patients underwent PTE, BPA, or medical management after consensus evaluation by a multidisciplinary team including pulmonary hypertension physicians, surgeons, interventional cardiologists, and radiologists. 86% (142/166) of patients underwent interventional therapies; 100 (60%) underwent PTE and 42 (25%) BPA. Of the 24 (14%) medically treated patients, 13 patients were offered but deferred intervention; 11 patients had non‐intervenable disease. 30‐day mortality in both PTE and BPA was 0%. 1‐ and 3‐year survival was 99% and 96% for PTE, 100% and 93% for BPA, 79% and 79% for medical management. Patients who underwent PTE had the best hemodynamic response (∆PVR: PTE −278.8 ± 366.9 dyne/sec/cm5; BPA −15.9 ± 171.8 dyne/sec/cm5; medical −60.2 ± 233.1 dyne/sec/cm5; p = 0.001), largest improvement in Borg Dyspnea Scale; [PTE −1.0 (−2.8 to 0.0), BPA + 0.5 (−0.8 to 5.0), medical +1.0 (0.75 to 3.0), p = 0.01], and most improvement in NYHA functional class [% improving at least 1 functional class: PTE 64% (47/73), BPA 18% (5/28), medical 21% (4/19), p = 0.0004].https://doi.org/10.1002/pul2.70085balloon pulmonary angioplastymultimodal therapypulmonary thromboendarterectomyteam‐based care |
| spellingShingle | S. Christopher Malaisrie Stephen Chiu Daniel Schimmel Maanasi Samant Ryan Avery Amir Rahsepar Bradley Allen Yasmin Raza Benjamin Freed Ruben Mylvaganam Michael J. Cuttica Outcomes of Multidisciplinary Care at a Chronic Thromboembolic Pulmonary Hypertension Center Pulmonary Circulation balloon pulmonary angioplasty multimodal therapy pulmonary thromboendarterectomy team‐based care |
| title | Outcomes of Multidisciplinary Care at a Chronic Thromboembolic Pulmonary Hypertension Center |
| title_full | Outcomes of Multidisciplinary Care at a Chronic Thromboembolic Pulmonary Hypertension Center |
| title_fullStr | Outcomes of Multidisciplinary Care at a Chronic Thromboembolic Pulmonary Hypertension Center |
| title_full_unstemmed | Outcomes of Multidisciplinary Care at a Chronic Thromboembolic Pulmonary Hypertension Center |
| title_short | Outcomes of Multidisciplinary Care at a Chronic Thromboembolic Pulmonary Hypertension Center |
| title_sort | outcomes of multidisciplinary care at a chronic thromboembolic pulmonary hypertension center |
| topic | balloon pulmonary angioplasty multimodal therapy pulmonary thromboendarterectomy team‐based care |
| url | https://doi.org/10.1002/pul2.70085 |
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