Pulmonary hypertension after pneumonectomy for lung cancer

摘要

Background:We aimed to consolidate our clinical observations regarding the development of pulmonary hypertension following pneumonectomy for lung cancer.Methods: Sixty-nine of 82 initially selected patients without pulmonary or cardiac comorbidities, who underwent pneumonectomy for lung cancer between October 2009 and October 2011, accomplished our protocol. Mean patient age was 60.6 years (range 44-78 years) and 10.1% were women.Results: Postoperative complications occurred in 16 (23.2%) patients. Mortality at 1, 12, and 18 months postoperatively was 4.3%, 15.9%, and 29%, respectively. One year postoperatively, 37.9% of patients developed mild to moderate pulmonary hypertension and 3.4% had severe pulmonary hypertension. The calculated mean pulmonary artery systolic pressure at 1, 6, and 12 months postoperatively was 21.9±6.6, 27.3±9.3, and 34.1±14mmHg, respectively (p<0.001). Receiver operating characteristic curve analysis showed a cutoff point at 35.5mmHg for late postoperative (at 12 months) pulmonary artery systolic pressure (sensitivity 80%, specificity 82%; p<0.001) related to suboptimal clinical outcomes (decreased performance status or death), with a detected 18-fold risk for these patients (p<0.001).Conclusions: Pulmonary hypertension may occur after pneumonectomy with its known adverse effects. Patients with late postoperative pulmonary artery systolic pressure>35.5mm Hg are at higher risk of a suboptimal clinical outcome.