Author + information
- Received December 3, 2017
- Revision received March 19, 2018
- Accepted April 3, 2018
- Published online May 21, 2018.
- Ehtisham Mahmud, MDa,∗ (, )@UCSDHealth,
- Michael M. Madani, MDb,
- Nick H. Kim, MDc,
- David Poch, MDc,
- Lawrence Ang, MDa,
- Omid Behnamfar, MDa,
- Mitul P. Patel, MDa and
- William R. Auger, MDc
- aDivision of Cardiovascular Medicine, University of California San Diego, La Jolla, California
- bDivision of Cardiothoracic Surgery, University of California San Diego, La Jolla, California
- cDivision of Pulmonary and Critical Care Medicine, Sulpizio Cardiovascular Center, University of California San Diego, La Jolla, California
- ↵∗Address for correspondence:
Dr. Ehtisham Mahmud, University of California San Diego, Sulpizio Cardiovascular Center, 9434 Medical Center Drive, La Jolla, California 92037.
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.
- balloon pulmonary angioplasty
- chronic thromboembolic pulmonary hypertension
- pulmonary thromboendarterectomy
Dr. Kim has been a consultant for Actelion, Bayer, and Merck; and has served on the Speakers Bureau for Bayer. Dr. Poch has been a consultant; and has served on the Speakers Bureau for Bayer. Dr. Auger has served as an advisory board member (uncompensated) for Bayer’s CTEPH Image Expert Panel; and has received research funding from Bayer for the CTEPH registry. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received December 3, 2017.
- Revision received March 19, 2018.
- Accepted April 3, 2018.
- 2018 The Authors
This article requires a subscription or purchase to view the full text. If you are a subscriber or member, click Login or the Subscribe link (top menu above) to access this article.