Chronic thromboembolic pulmonary hypertension – surgical treatment options and our experience
Background: Chronic thromboembolic pulmonary hypertension is an increasingly recognized cause of pulmonary hypertension. Th e prognosis of untreated patients is poor. Th e treatment of choice is the potentially curative pulmonary endarterectomy, which is feasible in more than half of the cases. Th e...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Slovenian Medical Association
2009-12-01
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| Series: | Zdravniški Vestnik |
| Online Access: | http://vestnik.szd.si/index.php/ZdravVest/article/view/412 |
| Summary: | Background: Chronic thromboembolic pulmonary
hypertension is an increasingly recognized
cause of pulmonary hypertension.
Th e prognosis of untreated patients is poor.
Th e treatment of choice is the potentially curative
pulmonary endarterectomy, which is
feasible in more than half of the cases. Th e
advances in operative techniques make pulmonary
endarterectomy possible even in patients
with very peripheral thromboemboli
in the subsegmental arteries. Due to rarity
of the disease it is advisable to perform the
procedure in experienced specialized centers
with high frequency of operations and thus
low perioperative risk. Patients with persistent
pulmonary hypertension aft er surgery
and patients who have inoperable disease
can be treated with vasodilators and remodulators
of pulmonary vasculature, which
improve prognosis to some extent. Th e fi nal
treatment option is lung transplantation.
Conclusions: Patients with chronic tromboembolic
pulmonary hypertension have to be
evaluated by a consultant surgeon with experience
in pulmonary endarterectomy. In the
last year two Slovenian patients were referred
from our clinic to the University hospital in
Vienna for pulmonary endarterectomy. Th e
treatment was successful with good followup
results. |
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| ISSN: | 1318-0347 1581-0224 |