Key result
Pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension has evolved from a high-mortality procedure to a widely performed curative surgery with lower complication rates.
Pulmonary thromboendarterectomy has evolved from a high-risk procedure at a single center to a widely performed, safer curative surgery for CTEPH, though the condition remains underdiagnosed.
May support expanded referral for CTEPH; leaves open optimal patient selection and real-world outcomes.
The modern era of surgery for chronic thromboembolic pulmonary hypertension (CTEPH) began just over 10 years ago. Until that time pulmonary thromboendarterectomy (PTE) was performed infrequently and essentially at a single medical center (University of California at San Diego-UCSD). It posed a formidable technical challenge and was associated with both high operative mortality (> 20%) and excessive morbidity due to respiratory and multiorgan system failure. Currently PTE is performed at numerous medical centers throughout the world, largely due to the pioneering efforts of those surgeons who developed and perfected the operation at UCSD. Operative mortality rates have fallen, and postoperative complications have become less common. Although no longer simply an autopsy curiosity, CTEPH continues to be an underdiagnosed condition. Increased awareness and better diagnosis will lead to curative surgery in more patients worldwide.
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Reneé S. Hartz (1999) conducted a review in chronic thromboembolic pulmonary hypertension (CTEPH). pulmonary thromboendarterectomy (PTE) was evaluated. Pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension has evolved from a high-mortality procedure to a widely performed curative surgery with lower complication rates.
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