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Pulmonary endarterectomy, chronic thromboembolic pulmonary hypertension

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https://www.readbyqxmd.com/read/28420842/the-development-of-marked-collateral-circulation-due-to-inferior-vena-cava-filter-occlusion-in-a-patient-with-chronic-thromboembolic-pulmonary-hypertension-complicated-with-anti-phospholipid-syndrome
#1
Hajime Kasai, Nobuhiro Tanabe, Ken Koshikawa, Yasutaka Hirasawa, Toshihiko Sugiura, Seiichiro Sakao, Koichiro Tatsumi
A 30-year-old Japanese man was diagnosed with chronic thromboembolic pulmonary hypertension (CTEPH) with lupus anticoagulants (LAs) in 2003. He underwent pulmonary endarterectomy after the placement of an inferior vena cava filter (IVCF) in 2004, and treatment with warfarin was continued. In 2014, IVCF occlusion and marked collateral circulation were noted during an examination for transient dyspnea; however, his warfarin level was within the therapeutic range for 88.9% of the time from 2003 to 2014. We herein report a rare case of CTEPH and LAs with IVCF occlusion; in such cases, intense treatment may be required...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28356406/balloon-pulmonary-angioplasty-in-chronic-thromboembolic-pulmonary-hypertension
#2
REVIEW
Irene Lang, Bernhard C Meyer, Takeshi Ogo, Hiromi Matsubara, Marcin Kurzyna, Hossein-Ardeschir Ghofrani, Eckhard Mayer, Philippe Brenot
Chronic thromboembolic pulmonary hypertension (CTEPH) is thought to result from incomplete resolution of pulmonary thromboemboli that undergo organisation into fibrous tissue within pulmonary arterial branches, filling pulmonary arterial lumina with collagenous obstructions. The treatment of choice is pulmonary endarterectomy (PEA) in CTEPH centres, which has low post-operative mortality and good long-term survival. For patients ineligible for PEA or who have recurrent or persistent pulmonary hypertension after surgery, medical treatment with riociguat is beneficial...
March 31, 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/28356404/medical-management-of-chronic-thromboembolic-pulmonary-hypertension
#3
REVIEW
Joanna Pepke-Zaba, Hossein-Ardeschir Ghofrani, Marius M Hoeper
Chronic thromboembolic pulmonary hypertension (CTEPH) results from incomplete resolution of acute pulmonary emboli, organised into fibrotic material that obstructs large pulmonary arteries, and distal small-vessel arteriopathy. Pulmonary endarterectomy (PEA) is the treatment of choice for eligible patients with CTEPH; in expert centres, PEA has low in-hospital mortality rates and excellent long-term survival. Supportive medical therapy consists of lifelong anticoagulation plus diuretics and oxygen, as needed...
March 31, 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/28331450/pulmonary-thromboendarterectomy-for-pulmonary-hypertension-before-considering-transplant
#4
Hannah Kooperkamp, Inder Mehta, David Fary, Michael Bates
BACKGROUND: In cases of chronic thromboembolic pulmonary hypertension (CTEPH), referral for possible surgical intervention is important because surgery can be curative. Surgery necessitates cardiopulmonary bypass and deep circulatory arrest with pulmonary thrombectomy and bilateral endarterectomy (PTE). If surgery fails, lung transplant is the next best surgical option. Medical treatment is also an important adjunct. CASE REPORT: A 35-year-old female presented 3 months after a pulmonary embolus was found to be completely occluding her left pulmonary artery...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28316030/a-new-ct-score-as-index-of-hemodynamic-changes-in-patients-with-chronic-thromboembolic-pulmonary-hypertension
#5
Maria Barbara Leone, Marica Giannotta, Massimiliano Palazzini, Mariano Cefarelli, Sofia Martìn Suàrez, Enrico Gotti, Maria Letizia Bacchi Reggiani, Maurizio Zompatori, Nazzareno Galiè
PURPOSE: The aim of this study was to retrospectively assess the relationship between radiological and hemodynamic parameters in patients with chronic thromboembolic pulmonary hypertension (CTEPH). We introduced a new CT-score to evaluate hemodynamic changes, only employing CT-pulmonary angiography (CTPA). MATERIALS AND METHODS: 145 patients affected by CTEPH underwent hemodynamic and CTPA evaluation. Among these 145 patients, 69 underwent pulmonary endarterectomy (PEA) and performed a CTPA evaluation even after surgery...
March 18, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28298388/pulmonary-endarterectomy-in-the-management-of-chronic-thromboembolic-pulmonary-hypertension
#6
REVIEW
David Jenkins, Michael Madani, Elie Fadel, Andrea Maria D'Armini, Eckhard Mayer
Chronic thromboembolic pulmonary hypertension (CTEPH) is a type of pulmonary hypertension, resulting from fibrotic transformation of pulmonary artery clots causing chronic obstruction in macroscopic pulmonary arteries and associated vascular remodelling in the microvasculature.Pulmonary endarterectomy (PEA) offers the best chance of symptomatic and prognostic improvement in eligible patients; in expert centres, it has excellent results. Current in-hospital mortality rates are <5% and survival is >90% at 1 year and >70% at 10 years...
January 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/28289496/surgical-treatment-of-chronic-thromboembolic-pulmonary-hypertension-pulmonary-thromboendarterectomy
#7
Michael M Madani
Pulmonary thromboendarterectomy (PTE), also referred to as pulmonary endarterectomy, is the definitive treatment for chronic thromboembolic pulmonary hypertension (CTEPH). The true incidence of CTEPH is unknown and difficult to ascertain; however, most experts agree that approximately 4% to 5% of all patients who have an acute episode of pulmonary embolism (PE) will continue to develop CTEPH. Based on an incidence rate of about 0.1% for acute PE, this translates into a CTEPH incidence of approximately 10,000 to 15,000 annually in the United States alone...
October 2016: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/28241922/pulmonary-hypertension
#8
Marius M Hoeper, Hossein-Ardeschir Ghofrani, Ekkehard Grünig, Hans Klose, Horst Olschewski, Stephan Rosenkranz
BACKGROUND: About 1% of adults suffer from pulmonary hypertension (PH). The various types of PH differ widely with respect to their incidence, clinical significance, and treatment. METHODS: Selective review of the literature in association with a consensus conference. RESULTS: Pulmonary hypertension is divided into five major categories. Those that are of particular clinical relevance are pulmonary arterial hypertension, chronic thromboembolic pulmonary hypertension, and pulmonary hypertension due to left heart and lung diseases...
February 3, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28218209/clinical-study-of-acute-vasoreactivity-testing-in-patients-with-chronic-thromboembolic-pulmonary-hypertension
#9
Qi-Xia Xu, Yuan-Hua Yang, Jie Geng, Zhen-Guo Zhai, Juan-Ni Gong, Ji-Feng Li, Xiao Tang, Chen Wang
BACKGROUND: The clinical significance of acute vasoreactivity testing (AVT) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) remains unclear. We analyzed changes in hemodynamics and oxygenation dynamics indices after AVT in patients with CTEPH using patients with pulmonary arterial hypertension (PAH) as controls. METHODS: We analyzed retrospectively the results of AVT in 80 patients with PAH and 175 patients with CTEPH registered in the research database of Beijing Chao-Yang Hospital between October 2005 and August 2014...
February 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28162796/-balloon-pulmonary-angioplasty-an-additional-treatment-option-to-improve-the-status-of-patients-with-chronic-thromboembolic-pulmonary-hypertension
#10
H Bouvaist
In chronic thromboembolic pulmonary hypertension (CTEPH), stenoses or obstructions of the pulmonary arteries due to organized thrombi can cause an elevation in pulmonary artery resistance, which in turn can result in pulmonary hypertension and progressive right heart failure. CTEPH can be cured surgically by pulmonary endarterectomy (PEA); however, patients deemed unsuitable for PEA due to distal lesion, advanced age, or comorbidities have a poor prognosis and limited treatment options. Recently, an alternative interventional strategy of balloon pulmonary angioplasty (BPA) reduces pulmonary artery hypertension in patients with CTEPH...
February 2017: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/28150849/from-thrombosis-to-fibrosis-in-chronic-thromboembolic-pulmonary-hypertension
#11
Magdalena L Bochenek, Nico S Rosinus, Mareike Lankeit, Lukas Hobohm, Felix Bremmer, Eva Schütz, Frederikus A Klok, Sven Horke, Christoph B Wiedenroth, Thomas Münzel, Irene M Lang, Eckhard Mayer, Stavros Konstantinides, Katrin Schäfer
The pathomechanisms underlying the development of thrombofibrotic pulmonary artery occlusions in Chronic Thromboembolic Pulmonary Hypertension (CTEPH) are largely unknown. The aim of this study was to allocate distinct cellular processes playing a role in thrombus resolution, such as inflammation, hypoxia, proliferation, apoptosis and angiogenesis, to different stages of thrombofibrotic remodelling. A total of 182 pulmonary endarterectomy (PEA) specimens were collected from 31 CTEPH patients. To facilitate co-localisation, Tissue MicroArrays were prepared and processed for (immuno)-histochemistry and confocal fluorescence microscopy...
April 3, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28145907/evaluation-of-reperfusion-pulmonary-edema-by-extravascular-lung-water-measurements-after-pulmonary-endarterectomy
#12
François Stéphan, Aurélien Mazeraud, Florent Laverdure, Julien Camous, Elie Fadel
OBJECTIVES: Reperfusion pulmonary edema is a specific complication of pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension. Extravascular lung water measurement may be valuable for diagnosing reperfusion pulmonary edema. The primary objective of this study was to describe and assess the clinical significance of extravascular lung water variations after pulmonary endarterectomy. DESIGN: Prospective observational study. SETTING: Nineteen-bed cardiothoracic ICU...
April 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28090289/an-international-physician-survey-of-chronic-thromboembolic-pulmonary-hypertension-management
#13
Henning Gall, Ioana R Preston, Barbara Hinzmann, Sabina Heinz, David Jenkins, Nick H Kim, Irene Lang
We conducted an international study to evaluate practices in the diagnosis and management of patients with chronic thromboembolic pulmonary hypertension (CTEPH) globally across different regions. Between August and October 2012, CTEPH-treating physicians completed a 15-minute online questionnaire and provided patient record data for their 2-5 most recent patients with CTEPH. Overall, 496 physicians (Europe: 260; United States: 152; Argentina: 52; Japan: 32) completed the questionnaire and provided patient record data for 1,748 patients...
December 2016: Pulmonary Circulation
https://www.readbyqxmd.com/read/28018819/a-technical-modification-for-establishing-selective-antegrade-cerebral-perfusion-during-pulmonary-endarterectomy
#14
Martin Czerny, Patrick von Samson, Bernward Passlick, Friedhelm Beyersdorf, Johannes Kroll
Pulmonary endarterectomy (PEA) due to chronic thromboembolic pulmonary hypertension (CTEPH) is mainly performed in deep hypothermic circulatory arrest without additional cerebroprotective means. A 49-year-old man was treated by PEA for CTEPH by using selective antegrade cerebral perfusion by advancing the tip of the systemic perfusion cannula into the brachiocephalic trunk. The postoperative course was uneventful.
December 2016: Thoracic and Cardiovascular Surgeon Reports
https://www.readbyqxmd.com/read/28011757/haemodynamic-effects-of-riociguat-in-inoperable-recurrent-chronic-thromboembolic-pulmonary-hypertension
#15
Nick H Kim, Andrea M D'Armini, Friedrich Grimminger, Ekkehard Grünig, Marius M Hoeper, Pavel Jansa, Eckhard Mayer, Claus Neurohr, Gérald Simonneau, Adam Torbicki, Chen Wang, Arno Fritsch, Neil Davie, Hossein-Ardeschir Ghofrani
OBJECTIVE: We compared the haemodynamic effects of riociguat in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH) or persistent/recurrent CTEPH after pulmonary endarterectomy in the Chronic Thromboembolic Pulmonary Hypertension Soluble Guanylate Cyclase-Stimulator Trial 1 study. METHODS: Patients with inoperable or persistent/recurrent CTEPH (n=261; mean± SD age 59±14 years; 66% women) were randomised to riociguat (up to 2.5 mg three times daily) or placebo...
April 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27970252/tct-90-efficacy-and-safety-of-sequential-hybrid-therapy-with-pulmonary-endarterectomy-and-additional-balloon-pulmonary-angioplasty-for-chronic-thromboembolic-pulmonary-hypertension
#16
Kenichi Yanaka, Kazuhiko Nakayama, Toshiro Shinke, Hiromasa Otake, Takayoshi Toba, Hachidai Takahashi, Daisuke Terashita, Yuto Shinkura, Koji Kuroda, Kenzo Uzu, Natsuko Tahara, Yoshinori Nagasawa, Yuichiro Nagano, Naoki Tamada, Yoshiro Tsukiyama, Hiroyuki Yamamoto, Noriaki Emoto, Ken-Ichi Hirata
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27966424/-diagnosis-and-treatment-of-chronic-thromboembolic-pulmonary-hypertension-in-denmark
#17
Charles Marinus Pedersen, Søren Mellemkjær, Jens Erik Nielsen-Kudsk, Kasper Korsholm, Gratien Andersen, Lars Bo Ilkjær
Chronic thromboembolic pulmonary hypertension (CTEPH) is an important differential diagnosis in patients with unexplained dyspnoea. CTEPH is under-recognized and carries a poor prognosis without treatment. Surgical pulmonary endarterectomy is the preferred treatment for the majority of patients. Advances in surgical and anaesthetic techniques and post-operative intensive treatment have reduced perioperative morbidity and mortality. Pulmonary endarterectomy results in major improvement of haemodynamics and clinical status and offers excellent long-term survival...
December 12, 2016: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/27956338/-from-acute-pulmonary-embolism-to-chronic-thromboembolic-pulmonary-hypertension-pathobiology-and-pathophysiology
#18
REVIEW
Miguel E Beltrán-Gámez, Julio Sandoval-Zárate, Tomás Pulido
Chronic thromboembolic pulmonary hypertension (CTEPH) represents a unique subtype of pulmonary hypertension characterized by the presence of mechanical obstruction of the major pulmonary vessels caused by venous thromboembolism. CTEPH is a progressive and devastating disease if not treated, and is the only subset of PH potentially curable by a surgical procedure known as pulmonary endarterectomy. The clot burden and pulmonary embolism recurrence may contribute to the development of CTEPH however only few thrombophilic factors have been found to be associated...
January 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/27783213/a-prospective-randomized-study-of-inhaled-prostacyclin-versus-nitric-oxide-in-patients-with-residual-pulmonary-hypertension-after-pulmonary-endarterectomy
#19
RANDOMIZED CONTROLLED TRIAL
Shinichiro Abe, Keiichi Ishida, Masahisa Masuda, Hideki Ueda, Hiroki Kohno, Kaoru Matsuura, Yusaku Tamura, Michiko Watanabe, Goro Matsumiya
OBJECTIVES: Pulmonary endarterectomy (PEA) is an effective treatment for chronic thromboembolic pulmonary hypertension (CTEPH), but postoperative residual hypertension leads to in-hospital mortality. Inhaled epoprostenol sodium (PGI2) and NO are administered for pulmonary hypertension after cardiothoracic surgery. This prospective study provides the first comparative evaluation of the effects of inhaled PGI2 and NO on pulmonary hemodynamics, systemic hemodynamics, and gas exchange in patients developing residual pulmonary hypertension after PEA...
March 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27760452/-chronic-thromboembolic-pulmonary-hypertension-recommendations-of-the-cologne-consensus-conference-2016
#20
REVIEW
H Wilkens, S Konstantinides, I Lang, A C Bunck, M Gerges, F Gerhardt, A Grgic, C Grohé, S Guth, M Held, J Hinrichs, M M Hoeper, W Klepetko, T Kramm, U Krüger, M Lankeit, B C Meyer, K M Olsson, H-J Schäfers, M Schmidt, H J Seyfarth, S Ulrich, C B Wiedenroth, E Mayer
The 2015 European Guidelines on Pulmonary Hypertension did not cover only pulmonary arterial hypertension (PAH), but also other significant subgroups of pulmonary hypertension (PH). In June 2016, a Consensus Conference organized by the PH working groups of the German Society of Cardiology (DGK), the German Society of Respiratory Medicine (DGP) and the German Society of Pediatric Cardiology (DGPK) was held in Cologne, Germany to discuss open and controversial issues surrounding the practical implementation of the European Guidelines...
October 2016: Deutsche Medizinische Wochenschrift
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