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Pulmonary endarterectomy, chronic thromboembolic pulmonary hypertension

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https://www.readbyqxmd.com/read/29776563/chronic-thromboembolic-pulmonary-hypertension-reversal-of-pulmonary-hypertension-but-not-sleep-disordered-breathing-following-pulmonary-endarterectomy
#1
Maria Teresa La Rovere, Francesco Fanfulla, Anna Eugenia Taurino, Claudio Bruschi, Roberto Maestri, Elena Robbi, Rita Maestroni, Caterina Pronzato, Maurizio Pin, Andrea M D'Armini, Gian Domenico Pinna
BACKGROUND: It has been hypothesized that pre-capillary pulmonary hypertension (PH) may trigger sleep disordered breathing (SDB). In patients with chronic thromboembolic PH (CTEPH), pulmonary endarterectomy (PEA) is potentially effective to improve PH. We assessed the pre- and post-operative prevalence of SDB in CTEPH patients submitted to PEA and the relationship between SDB and clinical, pulmonary and hemodynamic factors. METHODS: Unattended cardiorespiratory recording was performed the night before and one month after elective PEA in 50 patients...
August 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29730328/poor-subpleural-perfusion-predicts-failure-after-balloon-pulmonary-angioplasty-for-non-operable-chronic-thromboembolic-pulmonary-hypertension
#2
Yu Taniguchi, Philippe Brenot, Xavier Jais, Carlos Garcia, Jason Weatherald, Olivier Planche, Elie Fadel, Marc Humbert, Gérald Simonneau
BACKGROUND: Poor subpleural perfusion (PSP) in the capillary phase of pulmonary angiography predicts worse outcomes after pulmonary endarterectomy in operable chronic thromboembolic pulmonary hypertension (CTEPH). Balloon pulmonary angioplasty (BPA) has emerged for non-operable CTEPH. We assessed the association between PSP and BPA failure. METHOD: Subpleural perfusion was classified as poor (defined as subpleural spaces either not or minimally perfused in all segments) or normal...
May 3, 2018: Chest
https://www.readbyqxmd.com/read/29730148/mri-derived-regional-biventricular-function-in-patients-with-chronic-thromboembolic-pulmonary-hypertension-before-and-after-pulmonary-endarterectomy
#3
Sabine K Maschke, Christian O Schoenfeld, Till F Kaireit, Serghei Cebotari, Karen Olsson, Marius Hoeper, Frank Wacker, Jens Vogel-Claussen
RATIONALE AND OBJECTIVES: The aim of this study was to assess regional myocardial function in patients with chronic thromboembolic hypertension (CTEPH) before and after successful pulmonary endarterectomy (PEA) using magnetic resonance imaging. METHODS: Twenty-two patients with CTEPH underwent cardiac magnetic resonance imaging before and 12 (11, 17) days after PEA. Mean pulmonary artery pressure was evaluated preoperatively by right heart catheterization and during post-PEA intensive care unit-stay using a Swan-Ganz catheter...
May 2, 2018: Academic Radiology
https://www.readbyqxmd.com/read/29669971/after-the-dawn-balloon-pulmonary-angioplasty-for-patients-with-chronic-thromboembolic-pulmonary-hypertension
#4
Aiko Ogawa, Hiromi Matsubara
In the past 5 years, balloon pulmonary angioplasty (BPA) for patients with chronic thromboembolic pulmonary hypertension (CTEPH) who are deemed inoperable has undergone significant refinement. As a result, the procedure is now used worldwide and has become a promising therapeutic option for those patients. However, pulmonary endarterectomy remains the gold standard treatment for patients with CTEPH because the techniques and strategies for BPA are not yet unified. The best therapeutic option for each patient should be determined based on discussion among a multidisciplinary team of experts...
April 17, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29643129/vessel-stretching-is-a-cause-of-lumen-enlargement-immediately-after-balloon-pulmonary-angioplasty-intravascular-ultrasound-analysis-in-patients-with-chronic-thromboembolic-pulmonary-hypertension
#5
Hiroto Shimokawahara, Aiko Ogawa, Hiroki Mizoguchi, Hiroki Yagi, Hidekazu Ikemiyagi, Hiromi Matsubara
BACKGROUND: Balloon pulmonary angioplasty (BPA) has become an alternative therapy for patients with chronic thromboembolic pulmonary hypertension who are ineligible for pulmonary endarterectomy. We retrospectively investigated intravascular ultrasound measurements to elucidate how the lumen enlarges immediately after BPA. METHODS AND RESULTS: A total of 326 lesions in 71 patients with chronic thromboembolic pulmonary hypertension were analyzed. The cross-sectional areas (CSAs) of the external elastic membrane and lumen measured by intravascular ultrasound before and after BPA were assessed for each lesion type (type A, ring-like stenosis lesions; type B, web lesions; type C, subtotal occlusion lesions)...
April 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29615545/pulmonary-endarterectomy-for-patients-with-chronic-thromboembolic-disease
#6
Şehnaz Olgun Yıldızeli, Alper Kepez, Serpil Taş, Mehmed Yanartaş, Ali Fuad Durusoy, Atakan Erkılınç, Bülent Mutlu, Cihangir Kaymaz, Hasan Sunar, Bedrettin Yıldızeli
OBJECTIVE: Chronic thromboembolic disease (CTED) is characterized by persistent pulmonary thromboembolic occlusions without pulmonary hypertension. Early surgical treatment by performing pulmonary endarterectomy (PEA) may improve symptoms. The goal of the study was to review our experience and early outcome of PEA in patients with CTED. METHODS: Data were prospectively collected on all patients who underwent PEA between 2011 and 2015. Patients with CTED and a mean pulmonary artery pressure (mPAP) of <25 mm Hg were identified...
April 2018: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/29608809/chronic-thromboembolic-pulmonary-hypertension-from-the-perspective-of-patients-with-pulmonary-embolism
#7
REVIEW
Frederikus A Klok, Marion Delcroix, Harm Jan Bogaard
Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare but feared long-term complication of acute pulmonary embolism (PE), although CTEPH may occur in patients with no history of symptomatic venous thromboembolism. It represents the most severe presentation of the so-called 'post-PE syndrome', a phenomenon of permanent functional limitations after PE caused by deconditioning after PE or ventilatory or circulatory impairment due to unresolved pulmonary artery thrombi. Because the post-PE syndrome may occur in up to 50% of PE survivors, and CTEPH tends to have an insidious and non-specific clinical presentation, CTEPH is often not diagnosed or diagnosed after very long delay...
April 2, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29563354/adiponectin-in-chronic-thromboembolic-pulmonary-hypertension
#8
Sarasa Isobe, Masaharu Kataoka, Takashi Kawakami, Keiichi Fukuda
BACKGROUND: The correlation between serum adiponectin concentration and hemodynamics or certain metabolic markers in patients with chronic thromboembolic pulmonary hypertension (CTEPH) is unknown.Methods and Results:We enrolled 30 CTEPH patients who underwent interventional therapy of balloon pulmonary angioplasty or pulmonary endarterectomy. Serum adiponectin concentrations positively correlated with B-type natriuretic peptide (BNP) concentrations, pulmonary vascular resistance, and mean pulmonary arterial pressure...
March 21, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29550147/neuropsychological-outcomes-after-pulmonary-endarterectomy-using-moderate-hypothermia-and-periodic-circulatory-arrest
#9
Benedetta Vanini, Valentina Grazioli, Antonio Sciortino, Maurizio Pin, Vera N Merli, Anna Celentano, Ilaria Parisi, Catherine Klersy, Lucia Petrucci, Maurizio Salati, Pierluigi Politi, Andrea M D'Armini
BACKGROUND: In this prospective, single-center, observational study, we investigated the association between repeated short periods of circulatory arrest with moderate hypothermia during pulmonary endarterectomy (PEA) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) and different neuropsychological dimensions. METHODS: We examined 70 patients with CTEPH, >18 to 80 years of age, who had been treated with PEA. Neuropsychological testing was performed...
February 19, 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29540628/long-term-outcome-of-chronic-thromboembolic-pulmonary-hypertension-at-a-single-japanese-pulmonary-endarterectomy-center
#10
Hideki Miwa, Nobuhiro Tanabe, Takayuki Jujo, Fumiaki Kato, Rie Anazawa, Keiko Yamamoto, Akira Naito, Hajime Kasai, Rintaro Nishimura, Rika Suda, Toshihiko Sugiura, Seiichiro Sakao, Keiichi Ishida, Masahisa Masuda, Koichiro Tatsumi
BACKGROUND: Several new treatments for chronic thromboembolic pulmonary hypertension (CTEPH) have appeared in recent years, which have led to changes in the treatment algorithm. Changes in survival rates and prognostic factors, however, have not been estimated so far.Methods and Results:Two hundred and eighty patients were diagnosed with CTEPH at Chiba University Hospital between June 1986 and June 2016. Survival rate was investigated by date of treatment initiation (group 1, 1986-1998; group 2, 1999-2008; group 3, 2009-2016)...
March 13, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29526325/prevention-and-treatment-of-the-chronic-thromboembolic-pulmonary-hypertension
#11
Raffaele Pesavento, Paolo Prandoni
Chronic thromboembolic pulmonary hypertension (CTEPH) is an uncommon and late complication of pulmonary embolism resulting from misguided remodelling of residual pulmonary thromboembolic material and small-vessel arteriopathy. CTEPH is the only form of pulmonary hypertension (PH) potentially curable by pulmonary endarterectomy (PEA). Unfortunately, several patients have either an unacceptable risk-benefit ratio for undergoing the surgical intervention or develop persistent PH after PEA. Novel medical and endovascular therapies can be considered for them...
April 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29481935/two-stage-treatment-using-balloon-pulmonary-angioplasty-and-pulmonary-endarterectomy-in-a-patient-with-chronic-thromboembolic-pulmonary-hypertension
#12
Takayuki Kawashima, Akihiro Yoshitake, Takashi Kawakami, Hideyuki Shimizu
We performed a 2-stage procedure combining balloon pulmonary angioplasty and pulmonary endarterectomy for a high-risk chronic thromboembolic pulmonary hypertension patient with high pulmonary vascular resistance. First, balloon pulmonary angioplasty was performed for distal lesions to improve hemodynamics and decrease the surgical risk. Subsequently, pulmonary endarterectomy was performed for proximal lesions, and the hemodynamics and symptoms improved dramatically. Our strategy was therefore found to be useful for treating a high-risk chronic thromboembolic pulmonary hypertension patient...
May 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29478193/balloon-pulmonary-angioplasty-in-patients-with-thromboembolic-pulmonary-hypertension
#13
REVIEW
Panagiotis Karyofyllis, Varvara Papadopoulou, Vassilis Voudris, Hiromi Matsubara
PURPOSE OF REVIEW: Chronic thromboembolic pulmonary hypertension (CTEPH) is the only potentially curable form of precapillary pulmonary hypertension. Although pulmonary endarterectomy (PEA) is the preferred management strategy, a significant number of CTEPH patients will have an inoperable disease. As drug therapy is not expected to offer relief from the mechanical component of the disease, the novel technique of balloon pulmonary angioplasty (BPA) has provided a new therapeutic option for patients with inoperable CTEPH...
February 24, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29450722/incidence-and-characteristics-of-chronic-thromboembolic-pulmonary-hypertension-in-germany
#14
Thorsten Kramm, Heinrike Wilkens, Jan Fuge, Hans-Joachim Schäfers, Stefan Guth, Christoph B Wiedenroth, Bettina Weingard, Doerte Huscher, David Pittrow, Serghei Cebotari, Marius M Hoeper, Eckhard Mayer, Karen M Olsson
BACKGROUND: The incidence of chronic thromboembolic pulmonary hypertension (CTEPH) is unknown. Previous studies from the United Kingdom and Spain have reported incidence rates of 1.75 and 0.9 per million, respectively. These figures, however, may underestimate the true incidence of CTEPH. METHODS: We prospectively enrolled patients newly diagnosed with CTEPH within 2016 in Germany. Data were obtained from the three German referral centers and from the German branch of COMPERA, a European pulmonary hypertension registry...
February 15, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29424201/hereditary-hyperhomocysteinemia-associated-with-nephrotic-syndrome-complicated-by-artery-thrombosis-and-chronic-thromboembolic-pulmonary-hypertension-a-case-report
#15
Paolo Ruggeri, Federica Lo Bello, Francesco Nucera, Michele Gaeta, Francesco Monaco, Gaetano Caramori, Giuseppe Girbino
We present here the case of a 30-year-old man with a long term history of nephrotic syndrome (NS) who developed an episode of acute left main pulmonary artery thrombosis complicated by a lung abscess. During the hospital admission was also identified a concomitant hyperhomocysteinemia. After an atypical resection of the left upper pulmonary lobe and the starting of long term anticoagulation the patient was discharged but did not attend the planned follow up visits until one year later when he was seen again for severe dyspnea and exercise intolerance...
December 19, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29398378/systolic-anterior-motion-of-the-mitral-valve-during-pulmonary-endarterectomy-in-a-patient-with-chronic-thromboembolic-pulmonary-hypertension
#16
Koji Hoshino, Koichi Takita, Masami Demura, Tomonori Kubo, Yuji Morimoto
No abstract text is available yet for this article.
April 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29373658/the-outcome-of-reoperative-pulmonary-endarterectomy-surgery
#17
Jason M Ali, John Dunning, Choo Ng, Steven Tsui, John E Cannon, Karen K Sheares, Dolores Taboada, Mark Toshner, Nick Screaton, Joanna Pepke-Zaba, David P Jenkins
OBJECTIVES: Pulmonary endarterectomy (PEA) is the treatment of choice for patients with chronic thromboembolic pulmonary hypertension (PH). Despite excellent outcomes following PEA, a small proportion of patients have residual proximal disease or present with recurrent chronic thromboembolic PH and may benefit from further surgery. The aim of this study was to analyse outcomes following reoperative PEA at a high-volume national tertiary referral centre for the management of chronic thromboembolic PH...
January 23, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29321405/reversible-parkinsonism-and-multiple-cerebral-infarctions-after-pulmonary-endarterectomy-in-a-patient-with-antiphospholipid-syndrome
#18
Mitsumasa Okano, Kazuhiko Nakayama, Naoki Tamada, Yuto Shinkura, Ken-Ichi Yanaka, Hiroyuki Onishi, Hidekazu Tanaka, Toshiro Shinke, Hiroshi Tanaka, Yutaka Okita, Noriaki Emoto, Ken-Ichi Hirata
Antiphospholipid syndrome (APS) is a cause of chronic thromboembolic pulmonary hypertension (CTEPH) and it is associated with an increased risk of postoperative neurological complications. We experienced a case of reversible parkinsonism after pulmonary endarterectomy (PEA) and subsequent multiple cerebral infarctions under standard anticoagulation therapy in a patient with CTEPH associated with APS. Strict management using a combination of antiplatelet and anticoagulation therapy should be considered in patients with a high titer of triple antiphospholipid antibodies in the perioperative period...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29321385/severe-compression-of-the-left-main-coronary-artery-in-a-patient-with-chronic-thromboembolic-pulmonary-hypertension
#19
Kayo Sugiyama, Nobusato Koizumi, Hitoshi Ogino
Extrinsic compression of the left main coronary artery (LMCA) can occur in patients with an enlarged pulmonary artery trunk secondary to severe pulmonary hypertension (PH). This phenomenon rarely occurs in PH; moreover, few reports have shown that chronic thromboembolic PH can be a triggering factor for this syndrome. Herein, we describe a patient with extrinsic compression of the LMCA with chronic thromboembolic PH who underwent pulmonary endarterectomy and coronary artery bypass grafting successfully. Intravenous ultrasonography (IVUS) was effective for detecting and assessing the compression...
January 10, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29318791/impact-of-balloon-pulmonary-angioplasty-on-hemodynamics-and-clinical-outcomes-in-patients-with-chronic-thromboembolic-pulmonary-hypertension-the-initial-korean-experience
#20
Woochan Kwon, Jeong Hoon Yang, Taek Kyu Park, Sung A Chang, Dong Seop Jung, Young Seok Cho, Sung Mok Kim, Tae Jung Kim, Hye Yoon Park, Seung Hyuk Choi, Duk Kyung Kim
BACKGROUND: The treatment of choice for chronic thromboembolic pulmonary hypertension (CTEPH) is pulmonary endarterectomy (PEA). However, not all patients are eligible for PEA, and some patients experience recurrence of pulmonary hypertension even after PEA. METHODS: Patients who underwent balloon pulmonary angioplasty (BPA) between December 2015 and April 2017 were enrolled from the Samsung Medical Center CTEPH registry. Enrolled patients underwent right heart catheterization, echocardiography, and 6-minute walk distance (6MWD) at baseline, 4 and 24 weeks after their first BPA session...
January 22, 2018: Journal of Korean Medical Science
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