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Chronic Thromboembolic Pulmonary Hypertension and Assessment of Right Ventricular Function in the Piglet
Published on: November 4, 2015
Chronic thromboembolic pulmonary hypertension.
Peter Fedullo1, Kim M Kerr, Nick H Kim
1Division of Pulmonary and Critical Care Medicine, University of California, San Diego, San Diego 92103, California, USA. pfedullo@ucsd.edu
American Journal of Respiratory and Critical Care Medicine
|February 19, 2011
Summary
Chronic thromboembolic pulmonary hypertension is now a treatable condition. Pulmonary thromboendarterectomy offers significant improvements, while medical therapies help manage persistent cases.
Area of Science:
- Cardiology
- Pulmonary Medicine
- Vascular Surgery
Background:
- Chronic thromboembolic pulmonary hypertension (CTEPH) has transitioned from a rare autopsy finding to a recognized, treatable condition.
- Significant advancements in surgical techniques and medical therapies have improved patient outcomes.
Purpose of the Study:
- To review the diagnostic approaches for CTEPH.
- To discuss current surgical and medical therapeutic options for CTEPH.
- To highlight areas requiring further research in CTEPH management.
Main Methods:
- Review of surgical outcomes, including mortality rates for pulmonary thromboendarterectomy (PTE).
- Evaluation of the efficacy of disease-modifying medical therapies for CTEPH.
- Analysis of patient outcomes post-PTE, including functional and hemodynamic improvements.
Main Results:
- Over 5,000 PTE procedures have been performed globally, with mortality rates of 4-7% in experienced centers.
- Low-risk patients undergoing PTE have reported mortality rates as low as 1.3%.
- Successful PTE leads to substantial improvements in right ventricular function, gas exchange, exercise capacity, and quality of life.
Conclusions:
- CTEPH is a potentially correctable cause of pulmonary hypertension with established surgical and medical treatments.
- Pulmonary thromboendarterectomy offers significant benefits for eligible patients.
- Medical therapies are valuable for patients unsuitable for surgery or with persistent disease, though less effective than PTE.
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