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Chronic Thromboembolic Pulmonary Hypertension: Evolving Therapeutic Approaches for Operable and Inoperable Disease.

Publication ,  Journal Article
Mahmud, E; Madani, MM; Kim, NH; Poch, D; Ang, L; Behnamfar, O; Patel, MP; Auger, WR
Published in: J Am Coll Cardiol
May 29, 2018

Chronic thromboembolic pulmonary hypertension (CTEPH), a rare consequence of an acute pulmonary embolism, is a disease that is underdiagnosed, and surgical pulmonary thromboendarterectomy (PTE) remains the preferred therapy. However, determination of operability is multifactorial and can be challenging. There is growing excitement for the percutaneous treatment of inoperable CTEPH with data from multiple centers around the world showing the clinical feasibility of balloon pulmonary angioplasty. Riociguat remains the only approved medical therapy for CTEPH patients deemed inoperable or with persistent pulmonary hypertension after PTE. We recommend that expert multidisciplinary CTEPH teams be developed at individual institutions. Additionally, optimal and standardized techniques for balloon pulmonary angioplasty need to be developed along with dedicated interventional equipment and appropriate training standards. In the meantime, the percutaneous revascularization option is appropriate for patients deemed inoperable in combination with targeted medical therapy, or those who have failed to benefit from surgery.

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Published In

J Am Coll Cardiol

DOI

EISSN

1558-3597

Publication Date

May 29, 2018

Volume

71

Issue

21

Start / End Page

2468 / 2486

Location

United States

Related Subject Headings

  • Pyrimidines
  • Pyrazoles
  • Pulmonary Embolism
  • Hypertension, Pulmonary
  • Humans
  • Fibrinolytic Agents
  • Enzyme Activators
  • Endarterectomy
  • Clinical Trials as Topic
  • Chronic Disease
 

Citation

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Mahmud, E., Madani, M. M., Kim, N. H., Poch, D., Ang, L., Behnamfar, O., … Auger, W. R. (2018). Chronic Thromboembolic Pulmonary Hypertension: Evolving Therapeutic Approaches for Operable and Inoperable Disease. J Am Coll Cardiol, 71(21), 2468–2486. https://doi.org/10.1016/j.jacc.2018.04.009
Mahmud, Ehtisham, Michael M. Madani, Nick H. Kim, David Poch, Lawrence Ang, Omid Behnamfar, Mitul P. Patel, and William R. Auger. “Chronic Thromboembolic Pulmonary Hypertension: Evolving Therapeutic Approaches for Operable and Inoperable Disease.J Am Coll Cardiol 71, no. 21 (May 29, 2018): 2468–86. https://doi.org/10.1016/j.jacc.2018.04.009.
Mahmud E, Madani MM, Kim NH, Poch D, Ang L, Behnamfar O, et al. Chronic Thromboembolic Pulmonary Hypertension: Evolving Therapeutic Approaches for Operable and Inoperable Disease. J Am Coll Cardiol. 2018 May 29;71(21):2468–86.
Mahmud, Ehtisham, et al. “Chronic Thromboembolic Pulmonary Hypertension: Evolving Therapeutic Approaches for Operable and Inoperable Disease.J Am Coll Cardiol, vol. 71, no. 21, May 2018, pp. 2468–86. Pubmed, doi:10.1016/j.jacc.2018.04.009.
Mahmud E, Madani MM, Kim NH, Poch D, Ang L, Behnamfar O, Patel MP, Auger WR. Chronic Thromboembolic Pulmonary Hypertension: Evolving Therapeutic Approaches for Operable and Inoperable Disease. J Am Coll Cardiol. 2018 May 29;71(21):2468–2486.
Journal cover image

Published In

J Am Coll Cardiol

DOI

EISSN

1558-3597

Publication Date

May 29, 2018

Volume

71

Issue

21

Start / End Page

2468 / 2486

Location

United States

Related Subject Headings

  • Pyrimidines
  • Pyrazoles
  • Pulmonary Embolism
  • Hypertension, Pulmonary
  • Humans
  • Fibrinolytic Agents
  • Enzyme Activators
  • Endarterectomy
  • Clinical Trials as Topic
  • Chronic Disease