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Seminars in Cardiovascular Medicine

The Journal of Lithuanian Heart Association

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1822-7767
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Pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension: A case report and review of the literature

Lina Gumbienė
  • Clinic of Cardiovascular Diseases, Faculty of Medicine, Vilnius University
  • Centre of Cardiology and Angiology, Vilnius University Hospital Santariskiu Klinikos
  • Centre of Cardiac Surgery, Vilnius University Hospital Santariskiu Klinikos
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Taida Ivanauskienė / Mindaugas Matačiūnas
  • Department of Radiology, Nuclear Medicine and Medical Physics, Faculty of Medicine, Vilnius University
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Rolandas Zablockis
  • Clinic of Infections, Chest Deseases, Dermatovenerology and Allergology, Faculty of Medicine, Vilnius University
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Raimondas Širmenis / Karolis Urbonas
  • Centre of Anestesiology, Intensive Care and Pain Management, Vilnius University Hospital Santariskiu Klinikos
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Rimantas Karalius
  • Clinic of Cardiovascular Diseases, Faculty of Medicine, Vilnius University
  • Centre of Cardiac Surgery, Vilnius University Hospital Santariskiu Klinikos
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2012-07-20 | DOI: https://doi.org/10.2478/v10287-012-0004-2

Pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension: A case report and review of the literature

Chronic thromboembolic pulmonary hypertension is a progressive and disabling disease with high morbidity and mortality. Pulmonary endarterectomy has been approved as a first choice treatment for chronic thromboembolic pulmonary hypertension with obstruction of proximal pulmonary arteries. The aim of the article is to describe our first experience in this kind of treatment. Diagnosis of chronic thromboembolic pulmonary hypertension, criteria for the surgery, operative technique and results, perioperative management are discussed.

  • Galie N, Hoeper MM, Humbert MJC, Torbicki A, Vachiery JL, Barbera JA et al. Guidelines for the diagnosis and treatment of pulmonary hypertension. The Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology and the European Respiratory Society, endorsed by the International Society of Heart and Lung Transplantation. Eur Heart J 2009; 30:2493-2537.Google Scholar

  • Riedel M, Stanek V, Widimsky J, Prerovsky I. Long-term follow-up of patients with pulmonary thromboembolism: Late prognosis and evolution of hemodynamic and respiratory data. Chest 1982; 81:151-158.Google Scholar

  • Lewczuk J, Piszko P, Jagas J, Porada A, Wojciak S, Sobkowicz B et al. Prognostic factors in medically treated patients with chronic pulmonary embolism. Chest 2001; 119:818-823.Google Scholar

  • Pengo V, Lensing AW, Prins MH, Marchiori A, Davidson BL, Tiozzo F et al. Incidence of chronic thromboembolic pulmonary hypertension after pulmonary embolism. N Engl J Med 2004; 350:2257-2264.Google Scholar

  • Becattini C, Agnelli G, Pesavento R, Sillingardi M, Poggio R, Talianni MR et al. Incidence of chronic thromboembolic pulmonary hypertension after a first episode of pulmonary embolism. Chest 2006; 130:172-175.Google Scholar

  • Keogh AM, Mayer E, Benza RL, Corris P, Dartevelle PG, Frost AE et al. Interventional and surgical modalities of treatment in pulmonary hypertension. J Am Coll Cardiol 2009; 54: Suppl. 1, S67-S77.Web of ScienceGoogle Scholar

  • Corsico AG, D'Armini AM, Cerveri I, Klersy C, Ansaldo E, Niniano R et al. Long-term outcome after pulmonary endarterectomy. Am J Respir Crit Care Med 2008; 178:419-424.Google Scholar

  • Klepetko W, Mayer E, Sandoval J, Trulock EP, Vachiery JL, Dartevelle P et al. Interventional and surgical modalities of treatment for pulmonary arterial hypertension. J Am Coll Cardiol 2004; 43:73S-80S.Web of ScienceGoogle Scholar

  • Mayer E. Surgical and post-operative treatment of chronic thromboembolic pulmonary hypertension. Eur Respir Rev 2010; 19:64-67.Google Scholar

  • Piazza G, Goldhaber SZ. Chronic thromboembolic pulmonary hypertension. N Engl J Med 2011; 364:351-360.Google Scholar

  • Tei C, Dujardin KS, Hodge DO, Bailey KR, McGoon MD, Tajik AJ et al. Doppler echocardiographic index for assessment of global right ventricular function. J Am Soc Echocardiogr 1996; 9:838-847.Google Scholar

  • Mayer E, Klepetko W. Techniques and outcomes of pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension. Proc Am Thorac Soc 2006; 3:589-593.Google Scholar

  • Mayer E, Jekins D, Linder J, D'Armini A, Klock J, Meyns B et al. Surgical management and outcome of patients with chronic thromboembolic pulmonary hypertension: Results from an international prospective registry. J Thorac Cardiovasc Surg 2011; 141:702-710.Web of ScienceGoogle Scholar

  • Hoeper MM, Mayer E, Simonneau G, Rubin LJ. Chronic thromboembolic pulmonary hypertension. Circulation 2006; 113:2011-2020.Google Scholar

  • Dartevelle P, Fadel E, Mussot S, Chapelier A, Herve P, de Perrot M et al. Chronic thromboembolic pulmonary hypertension. Eur Respir J 2004; 23:637-648.Google Scholar

  • AugerWR, Kim NH, Kerr KM, Test VJ, Fedullo PF. Chronic thromboembolic pulmonary hypertension. Clin Chest Med 2007; 28:255-269.Google Scholar

  • Egermayer P, Peacock AJ. Is pulmonary embolism a common cause of chronic pulmonary hypertension? Limitations of the embolic hypothesis. Eur Respir J 2000; 15:440-448.Google Scholar

  • Jamieson SW. Pulmonary thromboendarterectomy. Heart 1998; 79:118-120.Google Scholar

  • Thistlethwaite PA, Mo M, Madani MM, Deutsch R, Blanchard D, Kapelanski D et al. Operative classification of thromboembolic disease determines outcome after pulmonary endarterectomy. J Thorac Cardiovasc Surg 2002; 124:1203-1211.Google Scholar

  • Bonderman D, Skoro-Sajer N, Jakowitsch J, Adlbrecht C, Dunkler D, Taghavi S et al. Predictors of outcome in chronic thromboembolic pulmonary hypertension. Circulation 2007; 115:2153-2158.Google Scholar

  • Condliffe R, Kiely DG, Gibbs JS, Corris PA, Peacock AJ, Jenkins DP et al. Improved outcomes in medically and surgically treated chronic thromboembolic pulmonary hypertension. Am J Respir Crit Care Med 2008; 177:1122-1127.Google Scholar

  • Condliffe R, Kiely DG, Gibbs JSR, Corris PA, Peacock AJ, Jenkins DP et al. Prognostic and aetiological factors in chronic thromboembolic pulmonary hypertension. Eur Respir J 2009; 33:332-337.Web of ScienceGoogle Scholar

  • Couturaud F, Frachon I, Leroyer C. Chronic thromboembolic pulmonary hypertensions: a tribute to pulmonary endarterectomy. Eur Respir J 2009; 33:230-232.Google Scholar

  • Dentali F, Donadini M, Gianni M, Bertolini A, Squizatto A, Venco A et al. Incidence of chronic pulmonary hypertension in patients with previous pulmonary embolism. Thromb Res 2009; 124: 256-258.Google Scholar

  • Jamieson SW, Kapelanski DP, Sakakibara N, Manecke GR, Thistlethwaite PA, Kerr KM et al. Pulmonary endarterectomy: experience and lessons learned in 1,500 cases. Ann Thorac Surg 2003; 76:1457-1462.Google Scholar

  • Thistlethwaite PA, Madani M, Jamieson SW. Outcomes of pulmonary endarterectomy surgery. Semin Thorac Cardiovasc Surg 2006; 18:257-264.Google Scholar

  • Saouti N, Morshuis WJ, Heijmen RH, Snijder RJ. Long-term outcome after pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension: A single institution experience. Eur J Cardiothorac Surg 2009; 35:947-952.Web of ScienceGoogle Scholar

  • Rubens FD, Bourke M, Hynes M, Nicholson D, Kotrec B et al. Surgery for chronic thromboembolic pulmonary hypertension: Inclusive experience from a national referral center. Ann Thorac Surg 2007; 83:1075-1081.Google Scholar

  • Thistlethwaite PA, Kaneko K, Madani MM, Jamieson SW. Technique and outcomes of pulmonary endarterectomy surgery. Ann Thorac Cardiovasc Surg 2008; 14:274-282.Google Scholar

  • Kim NH. Assessment of operability in chronic thromboembolic pulmonary hypertension. Proc Am Thorac Soc 2006; 3:584-588.Google Scholar

  • Fedullo PF, Auger WR, Kerr KM, Rubin LJ. Chronic thromboembolic pulmonary hypertension. N Engl J Med 2001; 345:1465-1472.Google Scholar

  • Skoro-Sajer N, Hack N, Sadushi-Kolici R, Bonderman D, Jakowitsch J, Klepetko W et al. Pulmonary vascular reactivity and prognosis in patients with chronic thromboembolic pulmonary hypertension: a pilot study. Circulation 2009; 119:298-305.Web of ScienceGoogle Scholar

  • Doyle RL, McCrory D, Channick RN, Simonneau G, Conte J. Surgical treatments/interventions for pulmonary arterial hypertension: ACCP evidence-based clinical practice guidelines. Chest 2004; 126:63S-71S.Google Scholar

  • Mayer E. Surgical treatment of chronic thromboembolic pulmonary hypertension. Swiss Med Wkly 2006; 136:491-497.Google Scholar

  • Thistlethwaite PA, Kemp A, Du L, Madani MM, Jamieson S. Outcomes of pulmonary endarterectomy for treatment of extreme thromboembolic pulmonary hypertension. J Thorac Cardiovasc Surg 2006; 131:307-313.Google Scholar

  • Bonderman D, Wilkens H, Wakounig S, Schafers HJ, Jansa P, Lindner J et al. Risk factors for chronic thromboembolic pulmonary hypertension. Eur Respir J 2009; 33:325-331.Google Scholar

  • Tscholla D, Langera F, Wendlera O, Wilkensb H, Georgc T, Schafers HJ. Pulmonary thromboendarterectomy - risk factors for early survival and hemodynamic improvement. Eur J Cardiothorac Surg 2001; 19:771-776.Google Scholar

  • Freed DH, Thomson BM, Berman M, Tsui SSL, Dunning J, Sheares KK et al. Survival after pulmonary thromboendarterectomy: Effect of residual pulmonary hypertension. J Thorac Cardiovasc Surg 2011; 141:383-387.Google Scholar

  • Bresser P, Pepke-Zaba J, Jais X, Humbert M, Hoeper MM. Medical therapies for chronic thromboembolic pulmonary hypertension: an evolving treatment paradigm. Proc Am Thorac Soc 2006; 3:594-600.Google Scholar

  • Hughes RJ, Jais X, Bonderman D, Suntharalingam J, Humbert M, Lang I et al. The efficacy of bosentan in inoperable chronic thromboembolic pulmonary hypertension: A 1-year follow-up study. Eur Respir J 2006; 28:138-143.Google Scholar

  • Ghofrani HA, Schermuly RT, Rose F, Wiedemann R, Kohstall MG, Kreckel A et al. Sildenafil for long-term treatment of nonoperable chronic thromboembolic pulmonary hypertension. Am J Respir Crit Care Med 2003; 167:1139-1141.Google Scholar

  • Jais X, D'Armini AM, Jansa P, Torbicki A, Delcroix M, Ghofrani HA et al. Bosentan for treatment of inoperable chronic thromboembolic pulmonary hypertension: BENEFiT (Bosentan Effects in iNopErable Forms of chronic Thromboembolic pulmonary hypertension), a randomized, placebo-controlled trial. J Am Coll Cardiol 2008; 52:2127-2134.Google Scholar

  • Ghofrani HA, Hoeper MM, Halank M, Meyer FJ, Staehler G, Behr J et al. Riociguat for chronic thromboembolic pulmonary hypertension and pulmonary arterial hypertension: a phase II study. Eur Respir J 2010; 36:792-799.Web of ScienceGoogle Scholar

  • Kim NH. Riociguat: An upcoming therapy in chronic thromboembolic pulmonary hypertension? Eur Respir Rev 2010; 19:68-71.Google Scholar

  • Reesink HJ, Surie S, Kloek JJ, Tan HL, Tepaske R, Fedullo PF et al. Bosentan as a bridge to pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension. J Thorac Cardiovasc Surg 2010; 139:85-91.Google Scholar

  • Reichenberger F, Voswinckel R, Enke B, Rutsch M, El Fechtali E, Schmehl T et al. Long-term treatment with sildenafil in chronic thromboembolic pulmonary hypertension. Eur Respir J 2007; 30:922-927.Web of ScienceGoogle Scholar

  • Lang IM. Managing chronic thromboembolic pulmonary hypertension: pharmacological treatment options. Eur Respir Rev 2009; 18:24-28.Google Scholar

About the article


Published Online: 2012-07-20

Published in Print: 2012-01-01


Citation Information: Seminars in Cardiovascular Medicine, ISSN (Online) 1822-7767, DOI: https://doi.org/10.2478/v10287-012-0004-2.

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