Related Experiment Video

Updated: May 17, 2026

Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis
06:59

Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis

Published on: August 26, 2025

Surgical treatment of chronic thromboembolic pulmonary hypertension

David P Jenkins1, Michael Madani, Eckhard Mayer

  • 1Papworth Hospital, Cambridge, UK. david.jenkins@papworth.nhs.uk

The European Respiratory Journal
|November 13, 2012
PubMed

Insights

Chronic thromboembolic pulmonary hypertension (CTEPH) may be more common than previously thought. Pulmonary endarterectomy (PEA) offers the best cure, though surgical expertise is crucial for complex cases.

Area of Science:

  • Cardiology
  • Thoracic Surgery
  • Pulmonary Medicine

Background:

  • Chronic thromboembolic pulmonary hypertension (CTEPH) is potentially underdiagnosed.
  • Accurate diagnosis and surgical assessment are vital for patient management.
  • Operability assessment currently relies heavily on surgical experience due to lack of risk stratification.

Purpose of the Study:

  • To review the diagnostic and surgical management of CTEPH.
  • To highlight the importance of experienced surgical centers for pulmonary endarterectomy (PEA).
  • To discuss the technical aspects and outcomes of PEA.

Main Methods:

  • Review of diagnostic imaging for CTEPH operability.
  • Description of standard pulmonary endarterectomy (PEA) surgical techniques.
  • Discussion of deep hypothermic circulatory arrest in PEA.
  • Reference to the PEACOG trial regarding cognitive function post-PEA.

Main Results:

  • Pulmonary endarterectomy (PEA) is the primary curative treatment for CTEPH.
  • Challenges in PEA include managing distal disease and achieving complete dissection.
  • Post-operative complications like reperfusion pulmonary edema can occur.
  • In-hospital mortality for PEA is less than 5% at experienced centers.

Conclusions:

  • Referral to experienced centers is essential for suspected CTEPH patients.
  • PEA, despite its complexity, offers the best chance for cure.
  • Continued vigilance for post-operative complications is necessary.

More Related Videos

Chronic Thromboembolic Pulmonary Hypertension and Assessment of Right Ventricular Function in the Piglet09:22

Chronic Thromboembolic Pulmonary Hypertension and Assessment of Right Ventricular Function in the Piglet

Published on: November 4, 2015

Related Concept Videos

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
Pulmonary Embolism III: Nursing Management01:27

Pulmonary Embolism III: Nursing Management

A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers01:26

Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers

Receptor tyrosine kinase inhibitors (TKIs) and calcium channel blockers (CCBs) are two critical categories of drugs employed in the treatment of pulmonary artery hypertension (PAH). PAH is a disease that causes high blood pressure in the pulmonary arteries, resulting in chest pain, fatigue, and shortness of breath.
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists01:23

Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists

Prostacyclin receptor agonists are a class of therapeutic agents integral to managing pulmonary arterial hypertension (PAH). These drugs operate by mimicking the action of prostaglandin I2, or PGI2, a naturally occurring compound in the body.
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
Chronic Obstructive Pulmonary Disease-V: Management01:29

Chronic Obstructive Pulmonary Disease-V: Management

Managing Chronic Obstructive Pulmonary Disease (COPD) involves a multifaceted approach to reduce symptoms, prevent exacerbations, improve overall health status, and slow disease progression. Key strategies include lifestyle modifications, pharmacotherapy, supportive therapies, and, in some cases, surgery. Here is an overview of the primary COPD management strategies:
Smoking Cessation