Document Detail

Chronic thromboembolic pulmonary hypertension: an updated review.
MedLine Citation:
PMID:  18830069     Owner:  NLM     Status:  MEDLINE    
PURPOSE OF REVIEW: Venous thromboembolism is a spectrum of disease comprising deep vein thrombosis, thrombus in transit, acute pulmonary embolism, and chronic thromboembolic pulmonary hypertension (CTEPH) as a rare and late possible sequela. RECENT FINDINGS: On the basis of a prospective long-term study, the incidence of CTEPH is estimated at 3.8% within 2 years of all patients surviving an episode of symptomatic idiopathic pulmonary embolism. Young age, a large perfusion defect, and idiopathic clinical presentation are associated with a higher probability of CTEPH. Current pathophysiological concepts suggest a misguided thrombus resolution process that is triggered by infection, inflammation, autoimmunity, and malignancy. Diagnosis and therapy of CTEPH are interdisciplinary achievements and nowadays still based on a positive lung perfusion scan and for assessment of operability on a classical pulmonary angiography. Treatment of choice is surgical pulmonary endarterectomy of the pulmonary obstructions, which leads to restoration of normal pulmonary hemodynamics at rest in nearly 80% of patients. In expert centers, surgical mortality is under 10%. SUMMARY: CTEPH has emerged as a 'dual' pulmonary vascular disorder with major vessel vascular remodeling of thrombus organization, combined with a small vessel pulmonary arteriopathy that is a target for classic vasodilator treatments.
Irene M Lang; Walter Klepetko
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Current opinion in cardiology     Volume:  23     ISSN:  1531-7080     ISO Abbreviation:  Curr. Opin. Cardiol.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-02     Completed Date:  2009-03-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8608087     Medline TA:  Curr Opin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  555-9     Citation Subset:  IM    
Department of Internal Medicine II, Division of Cardiology, Austria.
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MeSH Terms
Chronic Disease
Hypertension, Pulmonary / etiology*,  pathology,  physiopathology,  surgery
Pulmonary Embolism / complications,  physiopathology*,  surgery
Venous Thromboembolism / complications,  physiopathology*,  surgery

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