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Pulmonary endarterectomy, chronic thromboembolic pulmonary hypertension

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https://www.readbyqxmd.com/read/28090289/an-international-physician-survey-of-chronic-thromboembolic-pulmonary-hypertension-management
#1
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
#2
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
#3
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...
December 23, 2016: 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
#4
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
#5
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
#6
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...
December 9, 2016: 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
#7
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...
October 25, 2016: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27760452/-chronic-thromboembolic-pulmonary-hypertension-recommendations-of-the-cologne-consensus-conference-2016
#8
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
https://www.readbyqxmd.com/read/27733022/long-term-outcomes-of-surgery-for-chronic-thromboembolic-pulmonary-hypertension-compared-with-medical-therapy-at-a-single-korean-center
#9
Soo Han Kim, Jae Won Lee, Jung-Min Ahn, Dae-Hee Kim, Jong-Min Song, Sang-Do Lee, Jae Seung Lee
Background/Aims: Pulmonary endarterectomy (PEA) is the gold standard for treating chronic thromboembolic pulmonary hypertension (CTEPH) in Western countries. The aim of this study was to investigate the long-term outcomes of performing PEA on CTEPH patients in comparison with medical therapy at a single Korean center. Methods: This retrospective study included 88 CTEPH patients. These patients were classified into the PEA group (n = 37) or non-PEA group (i.e., medical therapy; n = 51)...
October 13, 2016: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/27729418/novel-angiographic-classification-of-each-vascular-lesion-in-chronic-thromboembolic-pulmonary-hypertension-based-on-selective-angiogram-and-results-of-balloon-pulmonary-angioplasty
#10
Takashi Kawakami, Aiko Ogawa, Katsumasa Miyaji, Hiroki Mizoguchi, Hiroto Shimokawahara, Takanori Naito, Takashi Oka, Kei Yunoki, Mitsuru Munemasa, Hiromi Matsubara
BACKGROUND: Balloon pulmonary angioplasty (BPA) is an alternative therapy for patients with chronic thromboembolic pulmonary hypertension who are ineligible for standard therapy, pulmonary endarterectomy. Although there are several classifications of vascular lesions, these classifications are based on the features of the specimen removed during pulmonary endarterectomy. Because organized thrombi are not removed during balloon pulmonary angioplasty, we attempted to establish a new classification of vascular lesions based on pulmonary angiographic images...
October 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27683616/chronic-thromboembolic-pulmonary-hypertension-pregnancy-and-a-pulmonary-endarterectomy-a-rare-challenge
#11
Erika B Rosenzweig, Mauer Biscotti, Kirsten Cleary, Richard Smiley, Matthew D Bacchetta
It is well described that patients with group 1 forms of pulmonary arterial hypertension have a high risk of mortality during pregnancy and in the early postpartum period. However, to the authors' knowledge, the diagnosis and management of group 4 pulmonary hypertension due to chronic thromboembolic pulmonary hypertension (CTEPH) during pregnancy with early postpartum pulmonary endarterectomy (PEA) has not been previously reported. We report the case of a 28-year-old woman who received a diagnosis of CTEPH during her pregnancy, was managed as an inpatient by a multidisciplinary team throughout the pregnancy and early postpartum period, and underwent PEA 6 weeks after delivery...
September 2016: Pulmonary Circulation
https://www.readbyqxmd.com/read/27614712/prognostic-and-pathophysiological-marker-for-patients-with-chronic-thromboembolic-pulmonary-hypertension-usefulness-of-diffusing-capacity-for-carbon-monoxide-at-diagnosis
#12
Rika Suda, Nobuhiro Tanabe, Keiichi Ishida, Fumiaki Kato, Takashi Urushibara, Ayumi Sekine, Rintaro Nishimura, Takayuki Jujo, Toshihiko Sugiura, Ayako Shigeta, Seiichiro Sakao, Koichiro Tatsumi
BACKGROUND AND OBJECTIVE: Chronic thromboembolic pulmonary hypertension (CTEPH) is a progressive disease in some patients, despite improved treatments. Microvasculopathy has been implicated in the poor outcomes of patients with CTEPH. A reduction in the diffusing capacity for carbon monoxide (DLCO ) was previously suggested to indicate microvasculopathy in CTEPH patients; therefore, we assessed DLCO /alveolar ventilation (DLCO /VA ) as a prognostic and pathophysiological marker in CTEPH...
January 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/27594123/composite-indices-of-upstream-pulmonary-vascular-impedance-and-capacitance-do-not-help-in-identifying-patients-who-should-undergo-pulmonary-endarterectomy-in-chronic-thromboembolic-pulmonary-hypertension
#13
F Vanden Eynden, M Bol Alima, J Racape, B El Oumeiri, J-L Vachiéry, G Van Nooten
No abstract text is available yet for this article.
June 2016: Acta Cardiologica
https://www.readbyqxmd.com/read/27591244/how-does-pulmonary-endarterectomy-cure-cteph-a-clue-to-cure-pah
#14
Masahiko Oka, Ivan F McMurtry, Kaori Oshima
Chronic thromboembolic pulmonary hypertension (CTEPH) is a hot topic in the field of pulmonary hypertension, because many CTEPH patients are now curable by surgical pulmonary endarterectomy and more recently possibly by pulmonary balloon angioplasty. However, there are still uncertainties regarding the pathogenesis of CTEPH, specifically how and where the small vessel arteriopathy that is indistinguishable from that in pulmonary arterial hypertension (plexogenic arteriopathy) develops, and how pulmonary endarterectomy improves hemodynamics and possibly cures CTEPH...
September 2, 2016: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/27571267/severe-pulmonary-arteriopathy-is-associated-with-persistent-hypoxemia-after-pulmonary-endarterectomy-in-chronic-thromboembolic-pulmonary-hypertension
#15
Takayuki Jujo, Nobuhiro Tanabe, Seiichiro Sakao, Hatsue Ishibashi-Ueda, Keiichi Ishida, Akira Naito, Fumiaki Kato, Takao Takeuchi, Ayumi Sekine, Rintaro Nishimura, Toshihiko Sugiura, Ayako Shigeta, Masahisa Masuda, Koichiro Tatsumi
BACKGROUND: Chronic thromboembolic pulmonary hypertension (CTEPH) is characterized by occlusion of pulmonary arteries by organized chronic thrombi. Persistent hypoxemia and residual pulmonary hypertension (PH) following successful pulmonary endarterectomy (PEA) are clinically important problems; however, the underlying mechanisms remain unclear. We have previously reported that residual PH is closely related to severe pulmonary vascular remodeling and hypothesize that this arteriopathy might also be involved in impaired gas exchange...
2016: PloS One
https://www.readbyqxmd.com/read/27571006/medical-therapy-in-chronic-thromboembolic-pulmonary-hypertension
#16
Joanna Pepke-Zaba, Xavier Jais, Richard Channick
Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare but life-threatening condition resulting from unresolved thromboembolic obstructions. Pulmonary endarterectomy surgery is currently the standard of treatment, as it is potentially curative; however, not all cases are amenable to surgical intervention due to distal distribution of the organized thromboembolic material or the presence of comorbidities. Up to one-third of patients have persistent or recurrent pulmonary hypertension after pulmonary endarterectomy...
July 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27571005/pulmonary-endarterectomy-patient-selection-technical-challenges-and-outcomes
#17
Michael Madani, Eckhard Mayer, Elie Fadel, David P Jenkins
In chronic thromboembolic pulmonary hypertension, thromboemboli do not undergo resolution but instead become highly organized and fibrotic, resulting in obstruction of segments of the pulmonary vascular tree. Progressive pulmonary hypertension ensues, with substantial associated morbidity and mortality. Despite advances in medical therapy for some types of pulmonary hypertension, surgical pulmonary endarterectomy, also referred to as pulmonary thromboendarterectomy, remains the only potentially curative option for patients with chronic thromboembolic pulmonary hypertension...
July 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27571004/diagnostic-evaluation-of-chronic-thromboembolic-pulmonary-hypertension
#18
Deepa Gopalan, Daniel Blanchard, William R Auger
Pulmonary hypertension is defined by a mean pulmonary artery pressure greater than 25 mm Hg. Chronic thromboembolic pulmonary hypertension (CTEPH) is defined as pulmonary hypertension in the presence of an organized thrombus within the pulmonary vascular bed that persists at least 3 months after the onset of anticoagulant therapy. Because CTEPH is potentially curable by surgical endarterectomy, correct identification of patients with this form of pulmonary hypertension and an accurate assessment of surgical candidacy are essential to provide optimal care...
July 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27418685/exercise-physiological-responses-to-drug-treatments-in-chronic-thromboembolic-pulmonary-hypertension
#19
Athanasios Charalampopoulos, J Simon R Gibbs, Rachel J Davies, Wendy Gin-Sing, Kevin Murphy, Karen K Sheares, Joanna Pepke-Zaba, David P Jenkins, Luke S Howard
We tested the hypothesis that patients with chronic thromboembolic pulmonary hypertension (CTEPH) that was deemed to be inoperable were more likely to respond to drugs for treating pulmonary arterial hypertension (PAH) by using cardiopulmonary exercise (CPX) testing than those with CTEPH that was deemed to be operable. We analyzed CPX testing data of all patients with CTEPH who were treated with PAH drugs and had undergone CPX testing before and after treatment at a single pulmonary hypertension center between February 2009 and March 2013...
September 1, 2016: Journal of Applied Physiology
https://www.readbyqxmd.com/read/27377832/heart-rate-response-during-6-minute-walking-testing-predicts-outcome-in-operable-chronic-thromboembolic-pulmonary-hypertension
#20
Manuel Jonas Richter, Katrin Milger, Khodr Tello, Philipp Stille, Werner Seeger, Eckhard Mayer, Hossein A Ghofrani, Henning Gall
BACKGROUND: Six-minute walk test (6MWT) is routinely performed in chronic thromboembolic pulmonary hypertension (CTEPH) before pulmonary endarterectomy (PEA). However, the clinical relevance of heart rate response (ΔHR) and exercise-induced oxygen desaturation (EID) during 6MWT is remaining unknown. METHODS: Patients undergoing PEA in our center between 03/2013-04/2014 were assessed prospectively with hemodynamic and exercise parameters prior to and 1 year post-PEA...
2016: BMC Pulmonary Medicine
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