Role of pulmonary vascular resistance measurements in preoperative evaluation of candidates for pulmonary resection

Fee, Henry J.; Holmes, E. Carmack; Gewirtz, Harold S.; Ramming, Kenneth P.; Alexander, J.

doi:10.1016/s0022-5223(19)41235-x

Cited by 63 publications

(6 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The mean Doppler PAp (sys) in those patients who survived lung resection was identical to that in those who died perioperatively, and PAp (sys) did not have significant predictive value for operative survival in this series, while baseline lung function indices did. This finding contrasts with that of the earlier catheter‐based studies 17–20 . Rams et al .…”

Section: Discussioncontrasting

confidence: 92%

“…The study of Fee et al . showed catheter‐derived measurements of pulmonary vascular resistance to be better than resting lung function measurements at predicting mortality 18 . These studies did not provide pulmonary artery pressure or cardiac output data and again no statistical analysis was performed.…”

Section: Discussionmentioning

confidence: 99%

“…Fee et al . measured pulmonary vascular resistance using right heart catheterization at rest and during exercise and found that a high pulmonary vascular resistance predicted mortality better than simple pulmonary function tests 18 …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Pulmonary artery pressure and blood flow as predictors of outcome from lung cancer resection

et al. 2005

View full text Add to dashboard Cite

show abstract

Section: Discussioncontrasting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pulmonary artery pressure and blood flow as predictors of outcome from lung cancer resection

et al. 2005

View full text Add to dashboard Cite

show abstract

“…Apart from preoperative ventilatory function, the adequacy of pulmonary vascular bed and circulation after pneumonectomy may be crucial to predict postoperative respiratory failure and ARDS. Fee and colleagues [28] proposed preoperative assessment of pulmonary vascular resistance by right heart catheterization at rest and during exercise; they suggested that high pulmonary vascular resistance is a better predictor of mortality than simple pulmonary function tests, underlining a possible role of secondary pulmonary hypertension caused by a reduction in the pulmonary capillary bed as a determinant of post-pneumonectomy respiratory failure and ARDS.…”

Section: Discussionmentioning

confidence: 99%

Normalized Pulmonary Artery Diameter Predicts Occurrence of Postpneumonectomy Respiratory Failure, ARDS, and Mortality

Daffré

Prieto

Huang

et al. 2020

Cancers

View full text Add to dashboard Cite

Hypothesizing that pulmonary artery diameter is a marker of subclinical pulmonary hypertension, we assessed its impact on postoperative outcome in patients requiring pneumonectomy. Morphometric, clinical, and laboratory data were retrospectively retrieved from files of 294 consecutive patients treated by pneumonectomy for malignancy (289 NSCLC). Pulmonary artery was measured at bifurcation level on CT scan and normalized by body surface area. Median normalized pulmonary artery diameter (cut-off for analyses) was 14 mm/m2. Postoperatively, 46 patients required re-do intubation and 30 had acute respiratory distress syndrome (ARDS). Multivariate analysis showed that Charlson Comorbidity Index >5 (p = 0.0009, OR 3.8 [1.76–8.22]), right side of pneumonectomy (p = 0.013, OR 2.37 [1.20–4.71]), and higher normalized pulmonary artery diameter (p = 0.029, OR 2.16 [1.08–4.33]) were independent predictors of re-do intubation, while Charlson Comorbidity Index >5 (p = 0.018, OR 2.55 [1.17–5.59]) and higher normalized pulmonary artery diameter (p = 0.028, OR = 2.52 [1.10–5.77]) were independently associated with occurrence of ARDS. Post-operative mortality was 8.5%. Higher normalized pulmonary artery diameter, (p = 0.026, OR 3.39 [1.15–9.95]), right side of pneumonectomy (p = 0.0074, OR 4.11 [1.46–11.56]), and Charlson Comorbidity Index >5 (p = 0.0011, OR 5.56 [1.99–15.54]) were independent predictors of postoperative death. We conclude that pre-operative normalized pulmonary artery diameter predicts the risk of re-do intubation, ARDS and mortality in patients undergoing pneumonectomy for cancer.

show abstract

“…It is well known that pulmonary arterial hypertension is associated with various diseases, including left-sided heart disease, chronic obstructive pulmonary disease, interstitial pulmonary disorders, and pulmonary vascular disorders [ 15 , 11 , 16 ]. Moreover, several studies indicate that preoperative pulmonary hypertension may be a predictor of PCCs [ 7 , 6 , 8 ]. As we did not routinely perform Doppler echocardiography, we could not analyze the relationship between PA/A ratio and pulmonary arterial pressure in our patients.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary arterial enlargement predicts cardiopulmonary complications after pulmonary resection for lung cancer: a retrospective cohort study

Asakura

Mitsuboshi²,

Tsuji³

et al. 2015

J Cardiothorac Surg

View full text Add to dashboard Cite

BackgroundThe finding of pulmonary arterial enlargement on computed tomography has been reported to be associated with pulmonary hypertension. On the other hand, pulmonary hypertension is a known risk factor for thoracic surgery. We investigated whether pulmonary arterial enlargement predicts cardiopulmonary complications following pulmonary resection for lung cancer.MethodsWe reviewed 237 consecutive patients who underwent pulmonary resection for lung cancer. Preoperative patient characteristics (sex, age, Brinkman index, cardiopulmonary comorbidities, cardiothoracic ratio, pulmonary function, and pulmonary arterial enlargement) and surgical data (surgical procedure, pathological stage, postoperative complications, mortality, and length of postoperative hospital stay) were analyzed. In order to evaluate preoperative pulmonary arterial enlargement, we measured the diameter of the main pulmonary artery at its bifurcation and that of the ascending aorta at its widest point using chest computed tomography and calculated the ratio of the former diameter to the latter.ResultsIn all, 16 patients developed postoperative cardiopulmonary complications and 221 did not. One patient died from postoperative pneumonia. The mean age of patients who developed postoperative cardiopulmonary complications was significantly higher than that of those who did not (78 ± 5 years vs 69 ± 9 years, P = 0.0001). The pulmonary artery-to-ascending-aorta ratio was significantly higher in patients who developed postoperative complications than in those who did not (0.94 ± 0.15 vs. 0.81 ± 0.11, P = 0.03). Other preoperative patient characteristics and surgical data did not differ significantly between the groups. On multivariate analysis, pulmonary artery-to-ascending-aorta ratio (0.1-point increase; odds ratio 2.3, 95 % confidence interval 1.5–3.5; P = 0.0002) and age (1-year increase; odds ratio 1.2, 95 % confidence interval 1.1–1.3; P = 0.03) were found to be independent predictors of postoperative cardiopulmonary complications.ConclusionsA finding of pulmonary arterial enlargement on computed tomography is a potential predictor of postoperative cardiopulmonary complications after lung cancer surgery.

show abstract

Role of pulmonary vascular resistance measurements in preoperative evaluation of candidates for pulmonary resection

Cited by 63 publications

References 8 publications

Pulmonary artery pressure and blood flow as predictors of outcome from lung cancer resection

Pulmonary artery pressure and blood flow as predictors of outcome from lung cancer resection

Normalized Pulmonary Artery Diameter Predicts Occurrence of Postpneumonectomy Respiratory Failure, ARDS, and Mortality

Pulmonary arterial enlargement predicts cardiopulmonary complications after pulmonary resection for lung cancer: a retrospective cohort study

Contact Info

Product

Resources

About