{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T11:48:18Z","timestamp":1789559298582,"version":"build-2803163510"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Antiphospholipid syndrome (APS) is associated with venous thromboembolism, which can lead to chronic thromboembolic pulmonary hypertension (CTEPH). Despite treatment with pulmonary endarterectomy (PEA), some patients continue to experience pulmonary hypertension (PH), which is potentially caused by APS-related distal vasculopathy. The aim of this study was to assess persistent PH after surgery and to investigate post PEA outcomes, including immediate postoperative complications, hospitalizations within 1 year of surgery, and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective analysis of adult patients with CTEPH who underwent PEA. We included patients with and without APS. Data were obtained from the Saudi Pulmonary Hypertension Registry (2011\u20132022). We assessed immediate postoperative complications, rehospitalizations within 1\u202fyear, and mortality. Additionally, we evaluated patients with right heart catheterization 1\u202fyear before and after PEA for persistent PH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study included 37 patients with APS-CTEPH and 41 patients without APS. Persistent PH was observed in 43% of patients, with no significant difference between the groups. Notably, patients in the APS-CTEPH group who received pulmonary vasodilator therapy before PEA had a reduced risk of developing persistent PH. Postoperative complications were significantly higher in the APS-CTEPH group (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.002). Despite these risks, the 5-year survival rate was 98.3%, with no significant difference between the groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      APS is associated with a higher incidence of immediate postoperative complications and rehospitalizations within the 1\n                      <jats:sup>st<\/jats:sup>\n                      year after surgery. However, APS does not appear to increase the risk of persistent PH or affect long-term mortality in this cohort.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1736115","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T13:12:32Z","timestamp":1768396352000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Pulmonary endarterectomy in antiphospholipid syndrome: a retrospective analysis from the Saudi pulmonary hypertension registry"],"prefix":"10.3389","volume":"13","author":[{"given":"Noura","family":"Alturaif","sequence":"first","affiliation":[{"name":"Pulmonary Hypertension, Department of Lung Health, Organ Transplant Centre, King Faisal Specialist Hospital and Research Centre","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima K.","family":"Alduraibi","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Medicine, King Faisal Specialist Hospital and Research Centre","place":["Riyadh, Saudi Arabia"]},{"name":"Division of Rheumatology, Department of Medicine, Beth Israel Deaconess Medical Centre, Harvard Medical School","place":["Boston, MA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kris","family":"Marquez","sequence":"additional","affiliation":[{"name":"Analytics Data Centre, Organ Transplant Centre, King Faisal Specialist Hospital and Research Centre","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fayez","family":"Alahmadi","sequence":"additional","affiliation":[{"name":"Pulmonary Hypertension, Department of Lung Health, Organ Transplant Centre, King Faisal Specialist Hospital and Research Centre","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadeen","family":"Alharbi","sequence":"additional","affiliation":[{"name":"Pulmonary Hypertension, Department of Lung Health, Organ Transplant Centre, King Faisal Specialist Hospital and Research Centre","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamdeia","family":"Zaytoun","sequence":"additional","affiliation":[{"name":"Pulmonary Hypertension, Department of Lung Health, Organ Transplant Centre, King Faisal Specialist Hospital and Research Centre","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanadi","family":"Alhamoud","sequence":"additional","affiliation":[{"name":"Pulmonary Hypertension, Department of Lung Health, Organ Transplant Centre, King Faisal Specialist Hospital and Research Centre","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima","family":"Alzubi","sequence":"additional","affiliation":[{"name":"Pulmonary Hypertension, Department of Lung Health, Organ Transplant Centre, King Faisal Specialist Hospital and Research Centre","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Hashim","sequence":"additional","affiliation":[{"name":"Thoracic Surgery, Department of Lung Health, Organ Transplant Centre, King Faisal Specialist Hospital and Research Centre","place":["Riyadh, Saudi Arabia"]},{"name":"Cardiothoracic Transplant Unit, Royal Papworth Hospital","place":["Cambridge, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pekka","family":"H\u00e4mm\u00e4inen","sequence":"additional","affiliation":[{"name":"Thoracic Surgery, Department of Lung Health, Organ Transplant Centre, King Faisal Specialist Hospital and Research Centre","place":["Riyadh, Saudi Arabia"]},{"name":"Vascular Service, Department of Surgery, Terveystalo Hospital","place":["Helsinki, Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"De Vol","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Epidemiology and Scientific Computing, King Faisal Specialist Hospital and Research Centre","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah M.","family":"Aldalaan","sequence":"additional","affiliation":[{"name":"Pulmonary Hypertension, Department of Lung Health, Organ Transplant Centre, King Faisal Specialist Hospital and Research Centre","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2010","DOI":"10.1056\/NEJMra1705454","article-title":"Diagnosis and management of the 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