This case report demonstrates the feasibility of managing CTEPH during pregnancy with a multidisciplinary approach and performing pulmonary endarterectomy in the early postpartum period.
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Case report supports individualized multidisciplinary CTEPH care in pregnancy with postpartum PEA; leaves open questions on safety and generalizability.
It is well described that patients with group 1 forms of pulmonary arterial hypertension have a high risk of mortality during pregnancy and in the early postpartum period. However, to the authors' knowledge, the diagnosis and management of group 4 pulmonary hypertension due to chronic thromboembolic pulmonary hypertension (CTEPH) during pregnancy with early postpartum pulmonary endarterectomy (PEA) has not been previously reported. We report the case of a 28-year-old woman who received a diagnosis of CTEPH during her pregnancy, was managed as an inpatient by a multidisciplinary team throughout the pregnancy and early postpartum period, and underwent PEA 6 weeks after delivery. While the management of acute pulmonary embolus in pregnancy is well described, this unique case of CTEPH diagnosed during pregnancy illustrates several challenging management issues.
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Rosenzweig et al. (2016) studied this question.
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