Bronchial carcinoma and pulmonary hypertension. Significance for lung resection

Abstract

In 227 patients with bronchial carcinoma whose forced expiratory volume was less than 2.5 l, measurements revealed a mild but significant rise in mean pulmonary arterial pressure at rest and on mild exercise (60 W). There was no clinically useful correlation between the degree of pulmonary hypertension and other measurable values, such as stage of the tumor or spirometric, whole-body plethysmographic, scintigraphic, electrocardiographic and blood-gas measurements. The degree of pre-operative pulmonary hypertension in 142 operated patients correlated with neither postoperative complications nor with post-operative mortality. Six months after lung resection there was a mild rise in pulmonary artery mean pressure among 30 patients, statistically significant only in those after pneumonectomy at rest. These results do not justify routine pre-operative right-heart catheterization. This should be reserved for patients with marginal ventilatory findings and cardiac risk factor.