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Thorac Cardiovasc Surg 2023; 71(05): 413-417
DOI: 10.1055/a-2059-4513
Original Thoracic

Surgical Treatment of Another Sequalae of COVID-19: Post-COVID CTEPH

Nezih Onur Ermerak
1   Department of Thoracic Surgery, Marmara University School of Medicine, Istanbul, Turkey
,
Sehnaz Olgun Yildizeli
2   Department of Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
,
Derya Kocakaya
2   Department of Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
,
Bulent Mutlu
3   Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey
,
Koray Ak
4   Department of Cardiovascular Surgery, Marmara University School of Medicine, Istanbul, Turkey
,
Serpil Tas
5   Department of Cardiovascular Surgery, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
,
Bedrettin Yildizeli
1   Department of Thoracic Surgery, Marmara University School of Medicine, Istanbul, Turkey
› Author Affiliations Funding None.
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Abstract

Background Coronavirus disease 2019 (COVID-19) is still an ongoing entity and every day we face new sequalae of the disease. We hereby present surgical results of patients who are treated for post-COVID chronic thromboembolic pulmonary hypertension.

Methods Data were collected among patients who underwent pulmonary endarterectomy and had a diagnosis of post-COVID chronic thromboembolic pulmonary hypertension. All data were retrospectively reviewed from a prospectively conducted database. Operative mortality was described as death in hospital or within 30 days of surgery.

Results Eleven patients (seven males, four females; median age, 52 [22–63] years) were identified. Pulmonary vascular resistance improved significantly from 572 dyn/s/cm−5 (240–1,192) to 240 (195–377) dyn/s/cm−5 (p < 0.005). Significant difference was also detected in median mPAP, as it decreased from 40 mm Hg (24–54) to 24 mm Hg (15–36) following surgery (p < 0.005). Mortality was observed in one patient due to sepsis on the fifth postoperative day. 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).

Conclusion In the new era of chronic thromboembolic pulmonary hypertension, hybrid approach including surgery, balloon pulmonary angioplasty, and medical treatment has been recommended. pulmonary endarterectomy is still the only curative treatment when the disease is surgically accessible. We hereby report the first publication of post-COVID chronic thromboembolic pulmonary hypertension patients who were surgically treated. As we see a lot of long-term symptoms and clinical manifestations in patients who had COVID-19, we should always remember chronic thromboembolic pulmonary hypertension in the differential diagnosis.

Keywords

COVID-19 - chronic thromboembolic pulmonary hypertension - post-COVID - long COVID - pulmonary endarterectomy


Publication History

Received: 03 January 2023

Accepted: 14 March 2023

Accepted Manuscript online:
21 March 2023

Article published online:
03 May 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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