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Chronic Thromboembolic Pulmonary Hypertension and Assessment of Right Ventricular Function in the Piglet
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Chronic thromboembolic pulmonary hypertension (CTEPH): Updated Recommendations from the Cologne Consensus Conference

Heinrike Wilkens1, Stavros Konstantinides2, Irene M Lang3

  • 1Department of Internal Medicine V - Pneumology, Allergology and Critical Care Medicine, University Hospital of Saarland, 66421 Homburg, Saar, Germany.

International Journal of Cardiology
|September 10, 2018
PubMed

Insights

Chronic thromboembolic pulmonary hypertension (CTEPH) requires exclusion in all suspected pulmonary hypertension cases. Treatment includes surgery (PEA) or targeted drug therapy for inoperable patients, with balloon pulmonary angioplasty (BPA) as an emerging option.

Area of Science:

  • Cardiology
  • Pulmonology
  • Vascular Medicine

Background:

  • Chronic thromboembolic pulmonary hypertension (CTEPH) is a distinct form of pulmonary hypertension.
  • Current European guidelines necessitate its consideration in all suspected pulmonary hypertension (PH) cases.
  • The Cologne Consensus Conference updated practical and controversial aspects of CTEPH management.

Purpose of the Study:

  • To provide updated recommendations for the diagnosis and treatment of CTEPH.
  • To emphasize the importance of excluding CTEPH and chronic thromboembolic disease (CTED) in PH patients.
  • To outline current treatment strategies, including surgical and medical options.

Main Methods:

  • Review and update of existing European Guidelines on Diagnosis and Treatment of Pulmonary Hypertension.
  • Consensus-based recommendations from a dedicated CTEPH working group.
  • Inclusion of practical and controversial issues in CTEPH management.

Main Results:

  • CTEPH and CTED must be excluded in all patients with suspected PH.
  • Surgical pulmonary endarterectomy (PEA) is the primary treatment for operable CTEPH patients.
  • Targeted drug therapy and balloon pulmonary angioplasty (BPA) are options for inoperable or persistent/recurrent CTEPH.

Conclusions:

  • Multidisciplinary centers are crucial for PEA and BPA.
  • Accurate diagnosis and timely intervention are key for managing CTEPH.
  • A stepwise approach considering PEA, drug therapy, and BPA optimizes patient outcomes.

Keywords:
Balloon pulmonary angioplastyChronic thromboembolic diseaseChronic thromboembolic pulmonary hypertensionMedical therapyPulmonary endarterectomy

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