Pulmonary endarterectomy in the management of chronic thromboembolic pulmonary hypertension
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Open Access
- 3 January 2017
- journal article
- review article
- Published by European Respiratory Society (ERS) in European Respiratory Review
- Vol. 26 (143), 160111
- https://doi.org/10.1183/16000617.0111-2016
Abstract
Chronic thromboembolic pulmonary hypertension (CTEPH) is a type of pulmonary hypertension, resulting from fibrotic transformation of pulmonary artery clots causing chronic obstruction in macroscopic pulmonary arteries and associated vascular remodelling in the microvasculature.Pulmonary endarterectomy (PEA) offers the best chance of symptomatic and prognostic improvement in eligible patients; in expert centres, it has excellent results. Current in-hospital mortality rates are 90% at 1 year and >70% at 10 years. However, PEA, is a complex procedure and relies on a multidisciplinary CTEPH team led by an experienced surgeon to decide on an individual's operability, which is determined primarily by lesion location and the haemodynamic parameters. Therefore, treatment of patients with CTEPH depends largely on subjective judgements of eligibility for surgery by the CTEPH team.Other controversies discussed in this article include eligibility for PEA versus balloon pulmonary angioplasty, the new treatment algorithm in the European Society of Cardiology/European Respiratory Society guidelines and the definition of an “expert centre” for the management of this condition.Keywords
This publication has 46 references indexed in Scilit:
- Evaluation of Patients with Chronic Thromboembolic Pulmonary Hypertension for Pulmonary EndarterectomyPulmonary Circulation, 2012
- State-of-the-art chronic thromboembolic pulmonary hypertension diagnosis and managementEuropean Respiratory Review, 2012
- Pulmonary Endarterectomy for Chronic Thromboembolic Pulmonary Hypertension: The Toronto ExperienceCanadian Journal of Cardiology, 2011
- Surgical management and outcome of patients with chronic thromboembolic pulmonary hypertension: Results from an international prospective registryThe Journal of Thoracic and Cardiovascular Surgery, 2011
- Survival after pulmonary thromboendarterectomy: Effect of residual pulmonary hypertensionThe Journal of Thoracic and Cardiovascular Surgery, 2011
- Guidelines for the diagnosis and treatment of pulmonary hypertension: The Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT)European Heart Journal, 2009
- Functional and haemodynamic outcome 1 year after pulmonary thromboendarterectomy☆European Journal of Cardio-Thoracic Surgery, 2008
- Predictors of Outcome in Chronic Thromboembolic Pulmonary HypertensionCirculation, 2007
- Reverse right ventricular remodeling after pulmonary endarterectomyThe Journal of Thoracic and Cardiovascular Surgery, 2007
- Venovenous Extracorporeal Life Support After Pulmonary Endarterectomy: Indications, Techniques, and OutcomesThe Annals of Thoracic Surgery, 2006