{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T12:25:40Z","timestamp":1788956740957,"version":"build-2803163510"},"reference-count":18,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objective<\/jats:title>\n                    <jats:p>The expected right atrial pressure (RAP) to pulmonary arterial wedge pressure (PAWP) ratio is &lt;\u20091. Inversion of this ratio (RAP \u2265 PAWP) has been linked to poor outcomes in pulmonary arterial hypertension, but its relevance in chronic thromboembolic pulmonary hypertension (CTEPH) is unknown. For patients undergoing pulmonary endarterectomy (PEA), this ratio may be associated with postoperative outcomes and guide postoperative management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed consecutive CTEPH patients who underwent PEA at the University of California San Diego from January 2021 to December 2023. RAP\/PAWP ratios \u2265\u20091 and &lt;\u20091 were compared for postoperative outcomes. Haemodynamic data were derived from preoperative right heart catheterization. Outcomes included reperfusion pulmonary edema (RPE), ventilator days, re\u2010intubation, ICU and hospital length of stay (LOS), and 30\u2010day mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 462 CTEPH patients met study criteria. Of these, 128 (27.7%) were in the inverse group (RAP\/PAWP \u2265\u20091) and 334 (72.3%) in the control group (RAP\/PAWP &lt;\u20091). The inverse group had worse baseline functional class, cardiac index, NT\u2010proBNP, and more haemoptysis. Postoperatively, rates of RPE (14% vs. 6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005) and re\u2010intubation (5% vs. 1%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.036) were higher in the inverse group. They also required more ventilator days (2 vs. 1,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and had longer ICU (4 vs. 3\u2009days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) and hospital LOS (13 vs. 11\u2009days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Thirty\u2010day mortality was numerically higher in the inverse group (3% vs. 1%), though not statistically significant (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.080).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      RAP\/PAWP ratio &gt;\u20091 prior to PEA surgery was associated with higher rates of early postoperative complications.\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/resp70255-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/resp.70255","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T05:44:07Z","timestamp":1777009447000},"page":"830-839","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Right Atrial Pressure\/Pulmonary Artery Wedge Pressure Ratio Correlates With Early Outcomes After Pulmonary Endarterectomy for Chronic Thromboembolic Pulmonary Hypertension"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8045-5041","authenticated-orcid":false,"given":"Cze Ci","family":"Chan","sequence":"first","affiliation":[{"name":"Division of Cardiology, Linkou Medical Center Chang Gung Memorial Hospital  Taoyuan City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e1rbara Lacerda","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Department of Cardiology Hospital de Santa Marta, Unidade Local de Sa\u00fade S\u00e3o Jos\u00e9  Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Bautista","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep Medicine, San Diego Health System University of California  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa D.","family":"Stinson","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep Medicine, San Diego Health System University of California  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thao T.","family":"Drcar","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep Medicine, San Diego Health System University of California  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny Z.","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep Medicine, San Diego Health System University of California  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona","family":"Alotaibi","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep Medicine, San Diego Health System University of California  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy M.","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep Medicine, San Diego Health System University of California  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8956-2357","authenticated-orcid":false,"given":"Demosthenes G.","family":"Papamatheakis","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep Medicine, San Diego Health System University of California  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S.","family":"Poch","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep Medicine, San Diego Health System University of California  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim M.","family":"Kerr","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep Medicine, San Diego Health System University of California  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael M.","family":"Madani","sequence":"additional","affiliation":[{"name":"Cardiovascular &amp; 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