Chronic obstructive pulmonary disease as a predictor of poor outcome of surgery for chronic thromboembolic pulmonary hypertension

Aim. The aim of this study was to investigate an influence of pulmonary ventilation and diffusion disorders on outcome of pulmonary endarterectomy. Methods. The study involved patients with chronic thromboembolic pulmonary hypertension (CTEPH) with (n = 43) or without (n = 88) chronic obstructive pulmonary disease (COPD). Body plethysmography and lung diffusing capacity measurement were performed in all patients before pulmonary endarterectomy. We analyzed perioperative clinical characteristics, complications and in-hospital mortality. Results. COPD was diagnosed twice more often in patients with CTEPH. Patients with CTEPH and COPD had more severe lung function disorders including more significant reduction in lung diffusing capacity. Comorbidity of COPD and CTEPH significantly increased a risk of respiratory failure in early postoperative period (OR = 2.1 (1.25-4.76), p = 0.020), length of hospitalization (p = 0.02), and a risk of in-hospital mortality (OR = 4.4 (1.21-16.19), p = 0.023). Lung diffusion capacity had an independent predictive value to predict the development of the respiratory failure in early postoperative period (OR = 1.8 (1.08-3.57), p = 0.050). Conclusion. Diagnosis of COPD in patients with CTEPH significantly increased risk of poor outcome of the pulmonary endarterectomy.