부산대학교 도서관

Background:Pulmonary Thromboendarterectomy (PTE) is a specialized cardiac surgery for treating chronic thromboembolic pulmonary hypertension (CTEPH). Sinus node dysfunction is seen in this population as patients often require epicardial pacing after cardiac surgeries. We aimed to define the incidence, predictors, and outcomes of sinus node dysfunction after PTE surgery.Hypothesis:We hypothesized that sinus node dysfunction requiring epicardial pacing is common after PTE surgery.Methods:We reviewed the charts of 883 consecutive patients who were referred to University of California San Diego for PTE. Demographics, lab results and imaging were extracted from chart review. Predictors and outcomes were analyzed using multivariate backward logistic regression model or independent samples T test respectively.Results:Overall, 60% (n=533) of patients required epicardial pacing for an average of 3.9 +/- 2.2 days. Strongest predictors of epicardial pacing were coronary artery disease (OR 2.6, p=<0.01) and tobacco abuse (OR 2.1, p=0.01). Of the patients who required epicardial pacing, only 1% (n=4) required permanent pacemaker placement. Patients who required epicardial pacing had significantly longer post-operative length of stays (12.9 days vs 11.3 days, p=<0.01) and ventilator days (2.3 days vs 1.8 days, p=0.02).Conclusions:The majority of patients undergoing PTE for chronic thromboembolic pulmonary hypertension develop sinus node dysfunction requiring temporary epicardial pacing. The mechanism of sinus node dysfunction appears transient as the average pacing requirement is 3.9 +/- 2.2 days, and ultimately only 1% (n=4) require permanent pacemaker placement. Patients who required epicardial pacing had significantly longer post-operative length of stay and ventilator days.