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Heart 2003;89:369-370; doi:10.1136/heart.89.4.369
Copyright © 2003 BMJ Publishing Group Ltd & British Cardiovascular Society
Heart 2003;89:369-370
© 2003 by BMJ Publishing Group & British Cardiac Society

EDITORIAL

Pulmonary thromboendarterectomy almost 50 years after the first surgical attempts

I Cerveri1, A M D’Armini2, M Viganò2

1 Division of Respiratory Diseases, IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
2 Department of Surgery and Organ Transplantation – Division of Cardiac Surgery, IRCCS Policlinico San Matteo University of Pavia, Italy

Correspondence to:
Correspondence to:
Dr Isa Cerveri, Clinica Malattie Apparato Respiratorio, Via Taramelli 5, 27100 Pavia, Italy;
i.cerveri@libero.it

With increased experience in preoperative evaluation, surgical approach and postoperative care of chronic thromboembolic pulmonary hypertension, pulmonary thromboendarterectomy can be performed with an acceptably low risk of death. Most patients, even those in a very compromised state, have excellent, long lasting results

Keywords: pulmonary thromboendarterectomy; chronic thromboembolic pulmonary hypertension

Abbreviations: CTEPH, chronic thromboembolic pulmonary hypertension; NYHA, New York Heart Association; PTE, pulmonary thromboendarterectomy; PVR, pulmonary vascular resistance

The first 150 words of the full text of this article appear below.

Chronic thromboembolic obstruction of the major pulmonary arteries is a potential long term consequence of acute pulmonary embolism.1 The actual prevalence of chronic thromboembolic pulmonary hypertension (CTEPH) is almost certainly underestimated.2 It is the only type of pulmonary hypertension that can be successfully treated with conservative surgery—that is, pulmonary thromboendarterectomy (PTE)—in selected patients.2–4 CTEPH of sufficient severity to warrant surgical intervention is much more common than previously suspected. Each year there are 500–2500 patients with this condition in the USA, accounting for 0.1–0.5% of patients with pulmonary emboli who survive.3

The PTE operation, as first performed at the University of California, San Diego,5 is now being systematically employed in about 10 centres around the world. Despite this, we concur with Jamieson’s editorial, published four years ago, which stated: "many physicians are unaware that a corrective operation exists, and rely instead on referral for transplantation or merely palliative medical treatment".2 There . . . [Full text of this article]


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This article has been cited by other articles:

  • Heinrich, M., Uder, M., Tscholl, D., Grgic, A., Kramann, B., Schafers, H.-J. (2005). CT Scan Findings in Chronic Thromboembolic Pulmonary Hypertension: Predictors of Hemodynamic Improvement After Pulmonary Thromboendarterectomy. Chest 127: 1606-1613 [Abstract] [Full Text]  

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