Pulmonary endarterectomy for the treatment of chronic thromboembolic pulmonary hypertension

ABSTRACT

Pulmonary endarterectomy is a curative treatment option for patients with chronic thromboembolic pulmonary hypertension (CTEPH). There is a growing body of evidence suggesting that not only patients with CTEPH but also patients with pulmonary arterial obstructions and mean pulmonary artery pressures < 25 mmHg should be offered surgery. In this review, the recent literature regarding pathophysiology, diagnostic methods, decision making by an expert CTEPH team, and surgical techniques will be summarized. Novel alternative treatment options for inoperable CTEPH patients will be discussed, i.e. targeted medical therapy and balloon pulmonary angioplasty. For the future the major task will be to define a clear selection process for the optimal treatment of the individual CTEPH patient.

KEYWORDS:

• Pulmonary endarterectomy
• PEA
• chronic thromboembolic pulmonary hypertension
• CTEPH
• pulmonary hypertension
• pulmonary embolism
• balloon pulmonary angioplasty
• BPA

Acknowledgements

The authors are grateful to Elizabeth Martinson, PhD, from the KHFI Editorial Office for her editorial assistance.

Financial & competing interests disclosure

S Guth has received speaking fees from Bayer, Pfizer and Actelion. T Kramm has received speaking fees from Bayer and Actelion. E Mayer has received speaking fees from Bayer, Pfizer, Actelion and GSK. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.