End-stage chronic thromboembolic pulmonary hypertension: is there still room for lung transplantation?—the past, the present and the future

Faccioli, Eleonora; Dell’Amore, Andrea

doi:10.21037/acs-2021-pte-139

Cited by 6 publications

(2 citation statements)

References 8 publications

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“…The 2019 International Society for Heart and Lung Transplantation (ISHLT) registries reported that only 1.5% of lung transplants performed worldwide are for non-idiopathic PH, so we can assume that the percentage of transplants performed for CTEPH is even lower. Lung transplant for CTEPH can be considered as a salvage option, only in highly selected cases as an alternative to failed PEA or as curative treatment in very peripheral thromboembolic disease not amenable to other drug or surgical treatment [ 73 ]. Some patients with CTEPH may have mixed anatomic lesions, with operable lesions in one lung and inoperable lesions in the other lung.…”

Section: Surgical Treatment: Pulmonary Endarterectomy (Pea)mentioning

confidence: 99%

Pathophysiology and Treatment of Chronic Thromboembolic Pulmonary Hypertension

Otani

Watanabe

Tomoe

et al. 2023

IJMS

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Chronic thromboembolic pulmonary hypertension (CTEPH) is a condition in which an organic thrombus remains in the pulmonary artery (PA) even after receiving anticoagulation therapy for more than 3 months and is complicated by pulmonary hypertension (PH), leading to right-sided heart failure and death. CTEPH is a progressive pulmonary vascular disease with a poor prognosis if left untreated. The standard treatment for CTEPH is pulmonary endarterectomy (PEA), which is usually performed only in specialized centers. In recent years, balloon pulmonary angioplasty (BPA) and drug therapy for CTEPH have also shown good results. This review discusses the complex pathogenesis of CTEPH and presents the standard of care, PEA, as well as a new device called BPA, which is showing remarkable progress in efficacy and safety. Additionally, several drugs are now demonstrating established evidence of efficacy in treating CTEPH.

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Section: Surgical Treatment: Pulmonary Endarterectomy (Pea)mentioning

confidence: 99%

Pathophysiology and Treatment of Chronic Thromboembolic Pulmonary Hypertension

Otani

Watanabe

Tomoe

et al. 2023

IJMS

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“…In this context, lung transplantation for CTEPH can be considered as a salvage option only in highly selected cases and in case of failure or exclusion from the above-mentioned options in case of residual PH or in case of inability to wean from ECMO after PEA [ 21 ]. Unfortunately, reports on lung transplantation in CTEPH are anecdotal and outcomes can only be extracted from few reports and are not satisfactory.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary Endarterectomy for Chronic Thromboembolic Pulmonary Hypertension: A Systematic Review of the Most Updated Literature

Faccioli

Verzeletti

Marra

et al. 2022

JCM

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Pulmonary endarterectomy (PEA) is the treatment of choice in case of chronic thromboembolic pulmonary hypertension (CTEPH). PEA is performed by an increasing number of surgeons; however, the reported outcomes are limited to a few registries or to individual centers’ experiences. This systematic review focuses on pre-operative evaluation, intra-operative procedure and post-operative results in patients submitted to PEA for CTEPH. The literature included was searched using a formal strategy, combining the terms “pulmonary endarterectomy” AND “chronic pulmonary hypertension” and focusing on studies published in the last 5 years (2017–2022) to give a comprehensive overview on the most updated literature. The selection of the adequate surgical candidate is a crucial point, and the decision should always be performed by expert multidisciplinary teams composed of surgeons, pulmonologists and radiologists. In all the included studies, the surgical procedure was performed through a median sternotomy with intermittent deep hypothermic circulatory arrest under cardiopulmonary bypass. In case of residual pulmonary hypertension, alternative combined treatments should be considered (balloon angioplasty and/or medical therapy until lung transplantation in highly selected cases). Short- and long-term outcomes, although not homogenous across the different studies, are acceptable in highly experienced CTEPH centers.

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