Contribution of cardiac implantable electronic devices (CIEDs) to thrombus formation in patients with chronic thromboembolic pulmonary hyptertension (CTEPH)
- Access
- Restricted to UC San Diego use only
- Collection
- Description
-
Chronic thromboembolic pulmonary hypertension (CTEPH) is a debilitating disease, now potentially curable with the advent of pulmonary thromboendarterectomy (PTE). This study aimed to identify the prevalence of cardiac implantable electronic devices (CIEDs) in the PTE population and describe associated disease burden. The contribution of CIEDs to thrombosis in this patient population has not been previously studied. The charts of 982 CTEPH patients, who underwent PTE between January 1, 2009 and December 31, 2015 at UC San Diego (UCSD) Medical Center, were reviewed for pacemaker or ICD leads implanted prior to surgery. All statistical analyses were completed using SPSS software. Continuous variables were analyzed with t-tests for normally distributed data; categorical variables were compared with chi-squares. Among 982 total CTEPH patients who underwent PTE, 14 had pacemakes and 3 had ICD leads, for a total of 17 CIEDs and a prevalence of 1.7%. Of these 17 CIEDs, 6 devices were extracted intraoperatively, and 5 of 6 devices were replaced with epicardial leads. Further more, of the 950 patients classified by intraoperative UCSD Level, 12 of 17 (70.6%) patients with CIEDs had distal disease versus 241 of 933 (25.8%) patients without CIEDs (p=.0002). The prevalence of known venous thromboemoblism (VTE) was 50% in CIED patients compared to 78.6% in patients without CIEDs (p=.018). There were no significant differences in demographics, preoperative hemodynamics, and postoperative hemodynamics between CTEPH patients with CIEDs and those without CIEDs. at 1.7%, the prevalence of CIEDs in the PTE population is higher than previously reported values, which estimated CIED prevalence between 0.16% and 0.47% in the general population. Moreover, CTEPH patients with CIEDs are more strongly associated with distal disease burden and less likely to have had prior VTE, suggesting that CIEDs may be a nidus for small clots which embolize distally in the pulmonary vasculature
- Creation Date
- 2018
- Creator
- Physical Description
-
1 online resource (9 unnumbered pages) : illustrations (some color)
- Note
-
Description based on online resource; title PDF cover page (viewed May 23, 2019)
Forms part of the UC San Diego School of Medicine independent study projects, Class of 2018
Includes bibliographical references
Title provided by the cataloger
- Genre
- Topic
Format
View formats within this collection
- Language
- English
- Publication
-
La Jolla, California: University of California, San Diego
- Thesis
-
M.D. University of California, San Diego 2018
- Rights Holder
- Nayak, Rohith
- Copyright
-
Under copyright (US)
Use: This work is available from the UC San Diego Library. This digital copy of the work is intended to support research, teaching, and private study.
Constraint(s) on Use: This work is protected by the U.S. Copyright Law (Title 17, U.S.C.). Use of this work beyond that allowed by "fair use" or any license applied to this work requires written permission of the copyright holder(s). Responsibility for obtaining permissions and any use and distribution of this work rests exclusively with the user and not the UC San Diego Library. Inquiries can be made to the UC San Diego Library program having custody of the work.
- Digital Object Made Available By
-
Academic Liaison Program, UC San Diego, La Jolla, 92093-0175 (http://ucsd.libguides.com/c.php?g=91092&p=584168)
- Last Modified
2020-10-28