Chronic thromboembolic pulmonary hypertension: Surgical treatment
- Peter F Fedullo, MD
Peter F Fedullo, MD
- Clinical Professor of Medicine
- University of California San Diego Medical Center
Surgery is the only definitive therapy for chronic thromboembolic pulmonary hypertension (CTEPH), with pulmonary thromboendarterectomy being the surgical procedure of choice [1-3]. Preparation for pulmonary thromboendarterectomy, the procedure itself, postoperative management, and outcomes following pulmonary thromboendarterectomy are reviewed here. The general approach to the treatment of CTEPH is described separately. (See "Overview of the treatment of chronic thromboembolic pulmonary hypertension".)
Surgery is the only potentially curative therapy for chronic thromboembolic pulmonary hypertension (CTEPH) and pulmonary thromboendarterectomy is the surgical procedure of choice. The decision to proceed to pulmonary thromboendarterectomy is based upon four criteria :
●The surgical accessibility of the thrombi
●The presence and severity of the hemodynamic and/or ventilatory impairment
●The impact of the patient's comorbidities on the risks of the surgery
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