Background The gold standard treatment of patients with chronic thromboembolic pulmonary
hypertension (CTEPH) is pulmonary endarterectomy (PEA). Little is known about the
influence of advanced age on surgical outcome. Therefore, the aim of this study was
to investigate the impact of patient's age on postoperative morbidity, mortality,
and quality of life in a German referral center. Methods Prospectively collected data
from 386 consecutive patients undergoing PEA between 01/2014 and 12/2016 were analyzed.
Patients were divided into three groups according to their age: group 1: <= 50 years,
group 2: > 50 <= 70 years, group 3: > 70 years. Results After PEA, distinct improvements
in pulmonary hemodynamics, physical capacity (World Health Organization [WHO] functional
class and 6-minute walking distance) and quality of life were found in all groups.
There were more complications in elderly patients with longer time of invasive ventilation,
intensive care, and in-hospital stay. However, the in-hospital mortality was comparable
(0% in group 1, 2.6% in group 2, and 2.1% in group 3 [ p = 0.326]). Furthermore, the
all-cause mortality at 1 year was 1.1% in group 1, 3.2% in group 2, and 6.3% in group
3 ( p = 0.122). Conclusions PEA is an effective treatment for CTEPH patients of all
ages accompanied by low perioperative and 1-year mortality. CTEPH patients in advanced
age carefully selected by thorough preoperative evaluation should be offered PEA in
expert centers to improve quality of life, symptoms, and pulmonary hemodynamics.
