Table. 1—

Recommendations for the diagnosis and pre-operative assessment of chronic thromboembolic pulmonary hypertension (CTEPH)

The diagnosis of CTEPH is based on the presence of pre-capillary PH (pa ≥25 mmHg, PWP ≤15 mmHg, PVR >2 Wood units) in patients with multiple chronic/organised occlusive thrombi/emboli in the elastic pulmonary arteries (main, lobar, segmental, subsegmental)IC
Once perfusion scanning and/or CT angiography show signs compatible with CTEPH, the patient should be referred to a centre with expertise in surgical pulmonary endarterectomyIIaC
The selection of patients for surgery should be based on the extent and location of the organised thrombi, on the degree of PH and on the presence of comorbiditiesIIaC
  • PH: pulmonary hypertension; pa: mean pulmonary arterial pressure; PWP: pulmonary wedge pressure; PVR: pulmonary vascular resistance; CT, computed tomography. #: I: evidence and/or general agreement that a given treatment or procedure is beneficial, useful or effective; II: conflicting evidence and/or a divergence of opinion about the usefulness/efficacy of the given treatment or procedure (IIa, weight of evidence/opinion is in favour of usefulness/efficacy); : C: consensus of opinion of the experts and/or small studies, retrospective studies or registries. Modified from [14].