Pulmonary arterial hypertension of chronic thromboembolic origin; therapeutic indications
Azarian, R.; Brenot, F.; Sitbon, O.; Parent, F.; Petitpretz, P.; Musset, D.; Grimon, G.; Dartevelle, P.; Simonneau, G.; Duroux, P.
Archives des Maladies du Coeur et des Vaisseaux 87(12): 1709-1713
1994
ISSN/ISBN: 0003-9683 PMID: 7786111 Document Number: 438325
Chronic thromboembolic pulmonary hypertension is a rare complication of acute pulmonary embolism. The therapeutic approach to the disease is addressed, based on a series of 81 patients referred to our department between 1984 and 1993. Medical treatment associates long-term anticoagulant therapy and, in some cases, inferior vena cava interruption. Two surgical procedures are available in selected patients: lung transplantation and pulmonary thrombo-endareterectomy. Lung transplantation has been performed in 8 patients since 1988 with 6 survivors with a maximal follow-up of 5 years. Twelve patients underwent pulmonary thromboendareterectomy with in 9 patients a dramatic functional and haemodynamic improvement. Chronic thromboembolism should be systematically investigated as the cause of pulmonary hypertension considering that in selected cases, curative surgery is possible.