[Chronic Thromboembolic Pulmonary Hypertension].

Area of Science:

• Cardiology
• Pulmonology
• Vascular Surgery

Background:

• Chronic thromboembolic pulmonary hypertension (CTEPH) is a late sequela of acute pulmonary embolism (PE).
• Pathophysiology involves pulmonary circulation narrowing due to inadequate thrombolysis and microvasculopathy, leading to increased pulmonary vascular resistance.
• Early detection is crucial as effective, potentially curative treatments are available.

Purpose of the Study:

• To outline the diagnostic and therapeutic strategies for CTEPH.
• To emphasize the importance of specialized centers and multidisciplinary teams for optimal patient management.
• To highlight the efficacy of multimodal treatment approaches.

Main Methods:

• Diagnosis requires high-quality imaging and hemodynamic evaluation via right heart catheterization.
• Treatment planning involves multidisciplinary team assessment at specialized centers.
• Therapeutic options include surgical pulmonary endarterectomy, balloon angioplasty for suitable lesions, and medical therapy for distal disease.

Main Results:

• Multimodal treatment strategies can achieve excellent outcomes for CTEPH patients.
• Surgical pulmonary endarterectomy is the preferred treatment when feasible.
• Balloon angioplasty serves as an alternative for specific lesions, often combined with medical therapy.
• The 3-year survival rate exceeds 90% with current multimodal treatment concepts.

Conclusions:

• CTEPH necessitates specialized diagnostic and treatment approaches.
• A combination of surgical, interventional, and medical therapies offers the best prognosis.
• Timely intervention at expert centers significantly improves long-term survival and quality of life for CTEPH patients.