Pulmonary Endarterectomy: A Stepwise Approach

      Chronic thromboembolic pulmonary hypertension (CTEPH) is an underdiagnosed complication of acute pulmonary embolism that is potentially curable with pulmonary thromboendarterectomy (PTE). Proper patient selection within the scope of a multidisciplinary team and detailed preoperative imaging is essential for successful outcomes. The operation itself is technically demanding and requires complete, bilateral endarterectomy down to the subsegmental branches on cardiopulmonary bypass with brief periods of deep hypothermic circulatory arrest. Finally, postoperative care is unique for PTE patients and is best conducted within the care of a multidisciplinary team.


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        • Gall H
        • Hoeper MM
        • Richter MJ
        • et al.
        An epidemiological analysis of the burden of chronic thromboembolic pulmonary hypertension in the USA, Europe and Japan.
        Eur Respir Rev. 2017; 26: 1-10
        • Yan L
        • Li X
        • Liu Z
        • et al.
        Research progress on the pathogenesis of CTEPH.
        Heart Fail Rev. 2019; 24: 1031-1040
        • Fedullo P
        • Kerr KM
        • Kim NH
        • et al.
        Chronic thromboembolic pulmonary hypertension.
        Am J Respir Crit Care Med. 2011; 183: 1605-1613
        • Riedel M
        • Stanek V
        • Widimsky J
        • et al.
        Longterm follow-up of patients with pulmonary thromboembolism. Late prognosis and evolution of hemodynamic and respiratory data.
        Chest. 1982; 81: 151-158
        • Tunariu N
        • Gibbs SJ
        • Win Z
        • et al.
        Ventilation-perfusion scintigraphy is more sensitive than multidetector CTPA in detecting chronic thromboembolic pulmonary disease as a treatable cause of pulmonary hypertension.
        J Nucl Med. 2007; 48: 680-684
        • Skoro-Sajer N
        • Marta G
        • Gerges C
        • et al.
        Surgical specimens, haemodynamics and long-term outcomes after pulmonary endarterectomy.
        Thorax. 2014; 69: 116-122
        • Jenkins D
        • Mayer E
        • Screaton N
        • et al.
        State-of-the-art chronic thromboembolic pulmonary hypertension diagnosis and management.
        Eur Respir Rev. 2012; 21: 32-39