Response by Cannon and Pepke-Zaba to Letter Regarding Article, “Dynamic Risk Stratification of Patient Long-Term Outcome After Pulmonary Endarterectomy: Results From the United Kingdom National Cohort”
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We thank Kataoka and colleagues for their comments about our article and the potential utility of percutaneous transluminal pulmonary angioplasty (PTPA) after pulmonary endarterectomy (PEA) surgery. Chronic thromboembolic pulmonary hypertension is described by a 2-compartmental model, with proximal vessel obstructions that are surgically accessible and a small vessel vasculopathy found in nonobstructed vessels. This explains why patients can have residual pulmonary hypertension post-PEA despite a good surgical clearance. In our cohort, we reported that 51% (397 of 788 patients who survived the operative period) had a mean pulmonary artery pressure of ≥25 mm Hg at reassessment.1 Despite this finding, the majority of patients remained in a good functional status with only 187 of 397 patients being …