P-207
APICAL PERFUSION FRACTION MAY NOT BE A PREDICTOR OF FUNCTIONAL OUTCOMES FOLLOWING BILATERAL LUNG VOLUME REDUCTION SURGERY

Objectives: Numerous studies have documented short-term improvement in functional outcomes after lung volume reduction surgery (LVRS). The response to LVRS, has not been uniform potentially limiting the clinical utility of the procedure. A prior study in which 128 subjects who underwent bilateral LVRS suggested that apical perfusion was helpful in predicting improvement in short-term functional outcomes. The aim of our study was to determine whether the apical perfusion fraction as measured by lung scintigraphy in our series of 88 patients predicted an improvement in functional outcome following bilateral LVRS.

Methods: We performed a retrospective analysis of 88 patients who were consented for bilateral LVRS at our institution. LVRS candidates were selected according to CMS inclusion/exclusion criteria and all had upper lobe predominant emphysema based on computed tomography (CT). Apical perfusion fraction (AP%), defined as the percentage of total lung perfusion to the apical one third of both lungs, was derived for each patient by quantitative scintigraphy technique. Subjects were classified into three groups according to AP: 32 patients (36.3%) had an AP% ≤10%, 45 patients (51.1%) had an AP% from 11 to 20%, and 11 patients (12.5%) had an AP% >20%. Analysis of variance (ANOVA) models were performed comparing the mean absolute changes (baseline to 6 months) across the three groups with respect to functional outcomes. the main functional outcomes analyzed included: forced expiratory volume in 1 second (FEV1 l), exercise capacity (watts), PO₂, UCSD shortness of breath questionnaire, and carbon monoxide diffusing capacity (DLCO).

Results: There was no statistically significant association between the AP% and mean absolute change six months post LVRS for any of the outcomes.

Conclusion: This retrospective analysis suggests that the measurement of apical perfusion by nuclear scintigraphy is not a significant predictor of functional improvement after LVRS.

Disclosure: No significant relationships.