RT Journal Article
SR Electronic
T1 Pulmonary endarterectomy in the management of chronic thromboembolic pulmonary hypertension
JF European Respiratory Review
JO EUROPEAN RESPIRATORY REVIEW
FD European Respiratory Society
SP 160111
DO 10.1183/16000617.0111-2016
VO 26
IS 143
A1 David Jenkins
A1 Michael Madani
A1 Elie Fadel
A1 Andrea Maria D'Armini
A1 Eckhard Mayer
YR 2017
UL http://err.ersjournals.com/content/26/143/160111.abstract
AB 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 <5% and survival is >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.Pulmonary endarterectomy in an expert centre is the treatment of choice for eligible patients with CTEPH http://ow.ly/T0kv308BGeY