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Surgery for chronic thromboembolic pulmonary hypertension
1Department of Surgery, Division of Cardiothoracic Surgery, Tulane University Medical School, 1430 Tulane Avenue, New Orleans, Louisiana 70112, USA.
World Journal of Surgery
|September 29, 1999
Summary
Pulmonary thromboendarterectomy (PTE) surgery for chronic thromboembolic pulmonary hypertension (CTEPH) has advanced significantly over the past decade. Improved techniques have reduced mortality and complications, making this life-saving surgery more accessible worldwide.
Area of Science:
- Cardiovascular Surgery
- Pulmonary Hypertension
- Vascular Surgery
Background:
- Chronic thromboembolic pulmonary hypertension (CTEPH) was historically associated with high-risk pulmonary thromboendarterectomy (PTE) at limited centers.
- PTE presented significant technical challenges, leading to high mortality rates exceeding 20% and substantial morbidity.
Purpose of the Study:
- To highlight the evolution and advancements in surgical treatment for CTEPH.
- To emphasize the global dissemination of PTE techniques pioneered at the University of California at San Diego (UCSD).
Main Methods:
- Review of the historical development and current practices of PTE for CTEPH.
- Analysis of changes in operative mortality and postoperative complication rates.
Main Results:
- PTE is now performed globally at multiple centers, a shift from its previous limited availability.
- Significant reductions in operative mortality and postoperative complications have been achieved.
- CTEPH remains underdiagnosed despite surgical advancements.
Conclusions:
- Surgical treatment for CTEPH has dramatically improved in safety and accessibility.
- Increased awareness and improved diagnostic methods are crucial for wider application of curative PTE.
- Further efforts are needed to address the underdiagnosis of CTEPH globally.