Surgical Ventricular Restoration for Advanced Congestive Heart Failure: Should Pulmonary Hypertension Be a Contraindication? Nishant D. Patel, BA, Jason.

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Surgical Ventricular Restoration for Advanced Congestive Heart Failure: Should Pulmonary Hypertension Be a Contraindication? Nishant D. Patel, BA, Jason A. Williams, MD, Lois U. Nwakanma, MD, Michele M. Waldron, RN, David A. Bluemke, MD, PhD, John V. Conte, MD The Annals of Thoracic Surgery Volume 82, Issue 3, Pages 879-888 (September 2006) DOI: 10.1016/j.athoracsur.2006.04.016 Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Preoperative mean pulmonary artery pressure (mPAP) in all patients undergoing surgical ventricular restoration. The Annals of Thoracic Surgery 2006 82, 879-888DOI: (10.1016/j.athoracsur.2006.04.016) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (a-d). Improvements in (a) pulmonary artery pressures (systolic = dotted line; mean = broken line, diastolic = solid line), (b) cardiac index (solid line; 95% confidence interval [CI] = dotted line), (c) pulmonary vascular resistance index (solid line; 95% CI = dotted line), and (d) right ventricular stroke work index (solid line; 95% CI = dotted line) for congestive heart failure patients with pulmonary hypertension. *p < 0.0001; ξp = 0.0001; †p = 0.03; ‡p < 0.0001. The Annals of Thoracic Surgery 2006 82, 879-888DOI: (10.1016/j.athoracsur.2006.04.016) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Actuarial survival of congestive heart failure patients with pulmonary hypertension (PHTN [dashed line]) and without PHTN (solid line) undergoing surgical ventricular restoration. The Annals of Thoracic Surgery 2006 82, 879-888DOI: (10.1016/j.athoracsur.2006.04.016) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Freedom from left ventricular assist device (LVAD), cardiac transplantation, and death among patients with pulmonary hypertension (PHTN [dashed line]) and without PHTN (solid line). The Annals of Thoracic Surgery 2006 82, 879-888DOI: (10.1016/j.athoracsur.2006.04.016) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Improvements in New York Heart Association (NYHA) class for patients with pulmonary hypertension (PHTN) and without PHTN. p < 0.05 for improvement in NYHA class. (Black bars = preoperative; gray bars = postoperative.) (Left) PHTN. (Right) No PHTN. The Annals of Thoracic Surgery 2006 82, 879-888DOI: (10.1016/j.athoracsur.2006.04.016) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions